New York State Minority Health Surveillance Report · Second, culturally and linguistically competent health care systems that ... Journal of Health Politics, Policy and Law, 31(1),

Public Health Information GroupOffice of Minority Health

Center for Community HealthOffice of Public Health

New York State Department of Health

County EditionDecember 2010

New York State

Minority HealthSurveillance Report

New York State Minority Health

Surveillance Report

County Edition December 2010

Public Health Information Group Office of Minority Health

Center for Community Health Office of Public Health

New York State Department of Health

Table of Contents

CONTENTS PAGE

Introduction …………………………………………………………………………………….5

Executive Summary…………………………………………………………………………….9

Format of the Report……………………………………………………………………….....22

HEALTH INDICATORS BY RACE/ETHNICITY, 2006- 2008

New York State Regions

New York State……………………...…………………………………………….……….27

New York City……………………………………………..………………………………29

New York State (excluding New York City)…………………….………………….……31

Counties

Albany ………………………………………………………………………………………33

Allegany ...………………………………………………………………………………… 35

Bronx …….…………………………………………………………………………………37

Broome …………….………………………………………………………………………..39

Cattaraugus …………………...……………………………………………………………41

Cayuga……………………………………………………………………………………....43

Chautauqua ………………………………………………………………………………...45

Chemung…………………………………………………………………………………….47

Chenango……………………………………………………………………………………49

Clinton ………………………………………………………………………………………51

Columbia…………………………………………………………………………………….53

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Table of Contents

Cortland ………………………………………………………………………….…………55

Delaware ……………………………………………………………………………………57

Dutchess …………………………………………………………………………………….59

Erie ………………………………………………………………………………………….61

Essex…………………………………………………………………………………………63

Franklin……………………………………………………………………….…………….65

Fulton …………………………………………………………………………….…………67

Genesee …………………………………………………………….……………….………69

Greene ..…………………………………..…………………………………………………71

Hamilton ……………………………………………………………………………...…….73

Herkimer ………………………………………………………………………...…………75

Jefferson ……………………………………………………………………………………77

Kings…………………………………………………………………………..………….…79

Lewis …………………………………………………………………………..……………81

Livingston …………………………………………………………………….………….…83

Nassau ………………………………………………………………………………………91

New York……………………………………………………………………………………93

Oneida ………………………………………………………………………………………97

Onondaga……………………………………………………………………………………99

Madison ………………………………………………………………………………….....85

Monroe ……………………………………………………………………………………..87

Montgomery ……………………………………………………………………………… 89

Niagara ..…………………………………………………………………………………….95

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Table of Contents

Ontario …………………………………………………………………………………….101

Orange……………………………………………………………………………………...103

Orleans …………………………………………………………………………………….105

Oswego …………………………………………………………………………………….107

Otsego………………………………………………………………………………………109

Putnam …………………………………………………………………………………….111

Rensselaer …………………………………………………………………………………115

Saratoga……………………………………………………………………………………123

Schenectady.……………………………………………………………………………….125

Seneca ….…….…………………………………………………………………………….131

Steuben….…………………………………………………….……………………………133

Suffolk …………..…………………………………………………………………………135

Sullivan……….……………………………………………………………………………137

Tioga………………………….……………………………………………………………139

Tompkins……………………..……………………………………………………………141

Warren…………………………..…………………………………………………………145

Queens……………………………………………………………………………………...113

Richmond…………………………………………………………………………………..117

Rockland………………………………………………………………………………….. 119

St. Lawrence ………………………………………………………………………………121

Schoharie .…………………………………………………………………………………127

Schuyler .…………………………………………………………………………………..129

Ulster ……………………………..………………………………………………………..143

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Table of Contents

Washington………………………………………………………………………………..147

Westchester ……………………………………………………………………………….151

Wyoming ………………………………………………………………………………….153

Yates………………………………………………………………………………………155

Wayne……………………………………………………………………………………...149

Population Map and Tables

Distribution of Minority Population by County, New York State, 2008 (Map)……...157

New York State Counties with Ten Percent or More Minority Population, Population by Race/Ethnicity, 2008 (Table)…………………………………………………………158

New York State Counties with Ten Percent or More Minority Population, Percent Population by Race/Ethnicity, 2008 (Table)……………………………………………159

Prevention Agenda 2013 Objectives for Selected Health Indicators .……………………..160

Appendices

Appendix 1 – Description of Data Sources…………………………………………161

Appendix 2 - Glossary/Technical Notes……..……………………………………...163

Acknowledgements……………………………………………………………………………164

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Introduction

As part of the overall effort to improve minority health in New York State, statute (Title II F-Section 242, Public Health Law, 1992) requires the New York State Department of Health (NYSDOH) to produce a biennial minority health report that includes an analysis of the health status of minority citizens. This report, The New York State Minority Health Surveillance Report-County Edition, is prepared and distributed in response to this charge.

Over the years, a number of reports have documented racial and ethnic differences in health status and health care access and quality for the 40% of New Yorkers who are racial and ethnic minorities. In 1906, in the monograph The Health and Physique of the Negro American,1 W.E.B. DuBois documented the poor health status of African Americans in comparison to White Americans. The body of evidence made available since then (e.g., the U.S. Department of Health and Human Services’(HHS) Health, United States 1983,2 Healthy People 2000,3 and Healthy People 2010,4 the Institute of Medicine’s Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare,5 and the Agency for Health Care Research and Quality’s 2003,6

2005,7 2006,8 and 20099 National Healthcare Disparities Reports) reveals that racial and ethnic minorities have less access to health care and poorer treatment outcomes than Whites. The 2009 National Healthcare Disparities Report focuses on the state of health care disparities for a group of “core” measures that represent the most important and scientifically credible measures of health care quality for the nation, as selected by the HHS Interagency Work Group.9 The report notes that for sizable proportions of measures, racial and ethnic minorities and poor people receive lower quality care. The report found that American Indians and Alaska Natives (AI/ANs) received worse care than Whites for 45% (9/20) of core measures and better care for 25% (5/20) of core measures; Hispanics received worse care than non-Hispanic Whites for 70% (14/20) of core measures and better care for 20% (4/20) of core measures; Blacks received worse care than Whites for 50% (10/20) of core measures and better care than Whites for 15% (3/20) of core measures; Asians received worse care than Whites for 30% (6/20) of core measures and better care for 40% (8/20) of core measures; poor people received worse care than high-income people for 75% (15/20) of core measures and better care for 5% (1/20) of core measures.

There is growing recognition that the vision for improving health of all people in the United States cannot be realized without addressing health disparities.10, 11 New York’s blueprint for improving the health of its population is described in NYSDOH’s Prevention Agenda Toward the Healthiest State (Prevention Agenda). The Prevention Agenda identifies ten priorities for improving the health of all New Yorkers and asks communities to work together to address them. The ten priority areas include measurable Prevention Agenda 2013 objectives and address the many health-related issues disproportionately faced by minority New Yorkers. The Prevention Agenda aims to reduce or eliminate racial, ethnic, and socioeconomic health disparities where they exist. Many of the indicators in this report are being used to measure progress toward achieving the state’s Prevention Agenda goals.

Accurate and quality data on race, ethnicity, and language are important prisms through which quality of care, utilization of health services, health outcomes, and satisfaction with health care

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services can be assessed and compared over time.12 Furthermore, these data are necessary to design and evaluate health disparity-reduction/elimination interventions.

The literature highlights three major themes regarding use of race and ethnicity data to raise the bar for providing high quality, evidence-based health care services. First is a growing recognition that disparities cannot be addressed if they are not identified.13 The Institute of Medicine5

emphasizes the necessity and importance of better data collection on race and ethnicity by health care organizations. Failure to collect, record, and use race and ethnicity data translates into missed opportunities to ensure the best possible care and to measure progress or lack of progress toward desired goals. Second, culturally and linguistically competent health care systems that reduce communication barriers 14, 15 must be data-driven. Third, race and ethnicity data help identify and quantify the impact of interventions to reduce racial and ethnic health disparities.16

The challenges associated with collecting race and ethnicity data have been well documented. 8,

12, 13 Two in particular are worth highlighting. First, there are disparities by race as well as by socio-economic status. These factors, while inter-related, are likely to play distinct, independent roles.10 Therefore, analysis of minority health status must take both into account.

A second important factor to consider is the availability and quality of the data. There are three types of data showing promise as effective tools to monitor health status of populations: patient and/or population-based assessments, medical/administrative record data audits, and health outcome data.17 Hospitalizations, vital records, and cancer registry data illustrate objective health outcomes. Existing data sources are used to track health disparities by measuring changes in morbidity, mortality, and risky health behaviors over time.

This New York State Minority Health Surveillance Report-County Edition assesses socio-demographic and health indicators for each county by race/ethnicity. The data illustrate: • variations in health outcomes across racial, ethnic, and income groups, • variations in health outcomes for each group by county, for New York City and for New

York State.

It is expected that this New York State Minority Health Surveillance Report-County Edition will raise awareness about minority health in New York State, including differences in health outcomes among racial and ethnic minorities residing in different locations of the state. These data can be used to develop and evaluate the effectiveness of evidence-based interventions for improving health outcomes. It is anticipated that future Minority Health Surveillance Reports will incorporate additional measures and expanded analyses of minority health status in New York State.

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References

1. DuBois, W.E.B. (Ed.). (1906). The Health and Physique of the Negro American. Cited in Gamble, V.N., & Stone, D. (2006). U.S. Policy on health inequities: The interplay of politics and research. Journal of Health Politics, Policy and Law, 31(1), 93-126.

2. U.S. Department of Health and Human Services. Health, United States 1983. Washington, DC: U.S. Public Health Service. DHHS Pub. No. (PHS) 84-1232. Cited in Nickens, H.A. (1991). The health status of minority populations in the United States. West J Med, 155, 27-32.

3. U.S. Department of Health and Human Services. Healthy People 2000: National health promotion and disease prevention objectives. Washington, DC: U.S. Public Health Service. DHHS Pub. No. (PHS) 91-50213.

4. U.S. Department of Health and Human Services. Healthy People 2010 (conference Edition, in Two Volumes). Washington, DC: Available at www.health.gov/healthypeople.

5. Smedley, B.D., Stith, A.Y., and Nelson, A.R. (Eds.). (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: The National Academies Press.

6. U.S. Department of Health and Human Services. 2003 National Healthcare Disparities Report. Agency for Healthcare Research and Quality. Washington, DC: Available at http://www.ahrq.gov/qual/nhdr03/nhdr03.pdf.

7. U.S. Department of Health and Human Services Agency for Healthcare Research and Quality. 2005 National Healthcare Disparities Report. Washington, DC: Available at http://www.ahrq.gov/qual/nhdr05/nhdr05.pdf.

8. U.S. Department of Health and Human Services. Agency for Healthcare Research and Quality. 2006 National Healthcare Disparities Report. Washington, DC: Available at http://www.ahrq.gov/qual/nhdr06/report/.

9. U.S. Department of Health and Human Services Agency for Healthcare Research and Quality. 2009 National Healthcare Disparities Report. Washington, DC: Available at http://www.ahrq.gov/qual/nhdr09/nhdr09.pdf.

10. Meyers, S.H. (2007). Racial and ethnic health disparities: Influences, actors, and policy opportunities. Kaiser Permanente Institute for Health Policy. Oakland, CA.

11. Agwunobi, J.O. Healthy People 2010 Midcourse Review. (Foreword). U.S. Department of Health and Human Services. Washington, DC: U.S. Public Health Service.

12. Regenstein, M., & Stickler, D. (2006). Race, ethnicity, and language of patients: Hospital practices regarding collection of information to address disparities in health care. Washington, DC: National Public Health and Hospital Institute.

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13. Llanos, K., & Palmer, L. (2006). Using data on race and ethnicity to improve health care quality for Medicaid beneficiaries. Center for Health Care Strategies, Inc., Hamilton, New Jersey.

14. Anderson, L.M., Scrimshaw, S.C., Fullilove, M.T., Fielding, J.E., & Normand, J. and the Task Force on Community Preventive Services. (2003). Culturally competent healthcare systems: A systemic review. Am J Prev Med, 24(3S), 68-78.

15. Brach, C., Fraser, I., & Paez, K. (2005). Crossing the language chasm: An in-depth analysis of what language programs look like in practice. Health Affairs, 24(2), 424-434.

16. Landon, B.E., Hicks, L.S., & O'Malley, A.J. et al. (2007). Improving the management of chronic disease at community health centers. New England Journal of Medicine, 356(9), 921–34.

17. Swift, E.K. (Ed.). (2002). Guidance for the national health care disparities report. Executive summary. Washington, DC: National Academies Press.

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Executive Summary

The Minority Health Surveillance Report–County Edition examines 47 health indicators by race/ethnicity and includes measures of socio-demographic status, birth outcomes, and prenatal care usage, and rates of hospitalizations and mortality for an array of chronic diseases and injury- related conditions for each county in New York State. Data are also presented for New York State as a whole, New York City, and New York State excluding New York City. In addition, the Minority Health Surveillance Report-County Edition includes a New York State map and corresponding table that identifies the state’s counties with at least 10% of their population from race/ethnic groups other than White non-Hispanic.

This report does not present health indicator information for the AI/AN population. Currently, the NYSDOH sources for this population contain poorly reported data. However, limited or poor quality state-level data on the AI/AN population is not unique to New York. According to a study by the Indian Health Service (IHS), there is significant miscoding of Indian race on State death certificates.1 Additionally, the AI/AN population in New York State is small. Overall, AI/ANs accounted for about 0.4% of New York State’s population (69,158) in 2008. Thus, analyzing data for this group at a county level would not be meaningful. The NYS Office of Minority Health is striving to present more detailed information regarding the health challenges and strengths of New York State’s AI/AN population. It is anticipated that this information will be available in the next Statewide Minority Health Surveillance Report.

Sub-groups within New York State’s diverse race/ethnic population face unique strengths and challenges in health. The following section highlights, for each racial/ethnic group, health indicators that reflect important population characteristics and show persistent disparities among groups.

Black non-Hispanic New York Residents

Socio-demographic

• In New York State, the Black non-Hispanic population was estimated to be about 3 million residents and accounted for 15.2% of New York State’s population in 2008. Sixty-eight percent of Black non-Hispanics resided in New York City.

• Among New York counties outside of New York City, Nassau County had the largest number of Black non-Hispanic residents (148,191). Monroe County had the highest percentage of Black non-Hispanic residents (14.4%) in 2008.

• During 2006-2008, 18.4% of Black** families in New York State were living in poverty. This is three times the rate for White non-Hispanic families (5.9%). In New York City, where the majority of this population resides, 18.4% were living in poverty.

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• Among counties outside of New York City with a population of at least 5,000 Black non-Hispanic residents, Rockland (6.0%) and Nassau (7.2%) counties had the lowest percentages of Black** families living in poverty. Counties with the highest percentages of Black** families living in poverty were Oneida (39.1%) and Niagara (37.0%).

• Median household income for New York State Black** residents was $40,522 during 2006-2008. This was below the median household income for White non-Hispanics ($63, 254) and Asians* ($60,024), and slightly higher than the median income for Hispanics ($38,688).

• New York City Black** residents had a median household income of $40,244 during 2006-2008. Among counties with a population of at least 5,000 Black non-Hispanics, Suffolk, Rockland and Nassau counties had the highest median incomes for Black** residents. These counties all had median household incomes greater than $67,000. The counties with the lowest median incomes for Black non-Hispanic residents were Erie ($25,904) and Oneida ($23,021).

* Poverty and median household income indicators are presented for Asians, which include both Hispanic and non-Hispanic Asians but do not include Pacific Islanders.

** Poverty and median household income indicators are presented for Blacks, which include both Hispanic and non-Hispanic Blacks.

General Health

• In New York State during 2006-2008, Black non-Hispanics had the highest age-adjusted total mortality rate (795.7 per 100,000) compared to all other race/ethnic groups. Black non-Hispanics residing in New York State outside of New York City had a total mortality rate of 850.5 per 100,000 while Black non-Hispanics residing in New York City had a mortality rate of 777.7 per 100,000.

• Among Black non-Hispanics who died in New York State during 2006-2008, 60.7% died prematurely (before the age of 75). This was the highest percentage of premature death among all race/ethnic groups. New York City Black non-Hispanics died prematurely (59.8%) at a lower rate than Black non-Hispanic residents of New York State outside of New York City (62.8%).

• Among counties with a population of at least 5,000 Black non-Hispanics, Rockland County had the lowest Black non-Hispanic percentage of premature death (53.4%) and Broome County had the highest (78.1%).

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Strengths

Although the Black non-Hispanic population of New York often experiences the worst health outcomes compared to other race/ethnic groups, this group has done better than most or all other race/ethnic groups in the following indicators:

• During 2006-2008, Black non-Hispanics had the lowest age-adjusted suicide mortality rate (3.6 per 100,000) compared to all other race/ethnic groups in New York State. The rate was also below New York State’s Prevention Agenda objective of 4.8 per 100,000. Black non-Hispanics residing in New York City had a lower rate (3.4 per 100,000) compared to Black non-Hispanics residing in New York State excluding New York City (3.9 per 100,000). Due to the relatively small number of suicides for this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

• The age-adjusted motor vehicle-related mortality rate among Black non-Hispanic New Yorkers, at 5.4 per 100,000, was lower than the White non-Hispanic rate of 8.1 per 100,000 and below New York State’s Prevention Agenda objective of 5.8 per 100,000 during 2006-2008. Black non-Hispanic residents of New York State excluding New York City experienced a higher rate (7.7 per 100,000) of motor vehicle-related mortality compared to their New York City counterparts (4.3 per 100,000). Due to the small number of deaths related to motor vehicles for this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

• The age-adjusted lung cancer incidence rate of 57.3 per 100,000 during 2003-2007 among Black non-Hispanic New Yorkers was considerably below the 70.7 per 100,000 rate for White non-Hispanics. Black non-Hispanic residents of New York City had a rate of 52.3 per 100,000 while Black non-Hispanic residents of New York State outside of New York City experienced a higher age-adjusted lung cancer incidence rate of 70.6 per 100,000. Due to the small number of lung cancer cases for this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

Challenges

The Black non-Hispanic population of New York State suffers disproportionately from numerous health problems compared to other race/ethnic groups. Some selected health indicators that pose challenges for this group include:

• During 2006-2008, the teen pregnancy rate for Black non-Hispanics was 69.0 per 1,000 females ages 15-17 years, which was more than 5 times the rate for White non-Hispanics and Asian/Pacific Islander non-Hispanics. The rate was also well above New York State’s Prevention Agenda objective of 28.0 per 1,000 females.

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• In New York City, the Black non-Hispanic teen pregnancy rate was 74.4 per 1,000 and in New York State excluding New York City the rate was 59.0 per 1,000. Among counties with at least 5,000 Black non-Hispanics, New York County had the highest Black non-Hispanic teen pregnancy rate (93.9 per 1,000) and Jefferson County had the lowest rate (12.9 per 1,000).

• During 2006-2008, the New York State Black non-Hispanic infant mortality rate, at 11.2 per 1,000, was more than twice that of White non-Hispanics and Hispanics and 4 times that of Asian/Pacific Islander non-Hispanics. The rate is also above New York State’s Prevention Agenda objective of 4.5 per 1,000.

• Black non-Hispanic residents of New York City had a lower rate of infant mortality (9.5 per 1,000) compared to Black non-Hispanic residents of New York State outside of New York City (15.2 per 1,000).

• Among counties with a population of at least 5,000 Black non-Hispanics, Queens County had the lowest Black non-Hispanic infant mortality rate (8.9 per 1,000) and Ulster County had the highest rate (32.6 per 1,000).

• The age-adjusted asthma hospitalization rate among Black non-Hispanics (44.3 per 10,000) was more than 4 times higher than the rate for White non-Hispanics (9.4 per 10,000) and Asian/Pacific Islander non-Hispanics (7.8 per 10,000) during 2006-2008. This rate was more than double New York State’s Prevention Agenda objective of 16.7 per 10,000.

• Black non-Hispanic residents of New York City had a higher asthma age-adjusted hospitalization rate (50.1 per 10,000) compared to Black non-Hispanic residents of New York State outside New York City (31.7 per 10,000) during 2006-2008.

• Among counties with a population of at least 5,000 Black non-Hispanics, Rockland County had the lowest Black non-Hispanic age-adjusted asthma hospitalization rate (21.2 per 10,000) and New York County had the highest rate (66.8 per 10,000).

• Black non-Hispanic New Yorkers had the highest age-adjusted rates of diabetes mortality (35.1 per 100,000) and hospitalizations (48.4 per 10,000) compared to all other race/ethnic groups during 2006-2008. Rates were similarly high whether Black non-Hispanics lived in or outside New York City.

• Among counties with a population of at least 5,000 Black non-Hispanics, Rockland County had the lowest Black non-Hispanic age-adjusted diabetes hospitalization rate (27.1 per 10,000) and Niagara County had the highest rate (81.9 per 10,000).

• The age-adjusted mortality rate for diseases of the heart was highest among Black non-Hispanics compared to all other race/ethnic groups in New York State during 2006-2008 (268.1 per 100,000).

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• Black non-Hispanic residents of New York City had a higher age-adjusted mortality rate due to diseases of the heart (274.9 per 100,000) compared to Black non-Hispanic residents of New York State excluding New York City (248.5 per 100,000). Among counties with a population of at least 5,000 Black non-Hispanics, Richmond County had the highest heart disease age-adjusted mortality rate among Black non-Hispanics (390.4 per 100,000) and Jefferson County had the lowest rate (148.7 per 100,000).

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Hispanic New York Residents

Socio-demographic

• In New York State, the Hispanic population was estimated to be about 3.3 million residents and accounted for 16.7% of New York State’s population in 2008. About 71% of Hispanics lived in New York City.

• Among counties outside New York City, Suffolk County had the largest number of Hispanics residents (207,326). Westchester County had the highest percentage of Hispanic residents (19.5%).

• During 2006-2008, 22.1% of Hispanic families in New York State were living in poverty. This is more than triple that of White non-Hispanics (5.9%). In New York City, where the majority of Hispanics resided, 24.8% were living in poverty.

• Among counties outside of New York City with a population of at least 5,000 Hispanics, Nassau (8.6%) and Suffolk (7.2%) counties had the lowest percentages of Hispanic families living in poverty. Counties with the highest percentage of Hispanic families living in poverty were Chautauqua (50.6%) and Erie (43.3%).

• Median household income for New York State Hispanic residents was $38,688 during 2006-2008. This was the lowest median household income for any race/ethnic group.

• New York City Hispanic residents had a median household income of $34,954 during 2006-2008. Among counties with a population of at least 5,000 Hispanics, Putnam and Nassau counties had the highest median incomes for Hispanic residents (greater than $70,000). The counties with the lowest median incomes for Hispanic residents were Chautauqua ($9,958) and Erie ($21,295).

General Health

• In New York State during 2006-2008, Hispanics had the second lowest age-adjusted total mortality rate (533.5 per 100,000) compared to White non-Hispanic, Black non-Hispanic, and Asian/Pacific Islander non-Hispanic residents. Asian/Pacific Islander non-Hispanics had the lowest rate. Hispanics in New York State outside New York City had a total mortality rate of 495.0 per 100,000 while Hispanics in New York City had a mortality rate of 545.4 per 100,000.

• Among Hispanics who died in New York State during 2006-2008, 60.5% died prematurely (before the age of 75). The only group with a higher percentage of premature death was Black non-Hispanics (60.7%). New York City Hispanics had a slightly lower percentage of premature death (60.0%) compared to Hispanic residents of New York State outside New York City (62.6%).

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• Among counties with a population of at least 5,000 Hispanics, Putnam County had the lowest Hispanic percentage of premature death (55.9%) and Broome County had the highest percentage (79.1%).

Strengths

Although Hispanics experience disparities in numerous health outcomes, this population also has a lower burden for some health indicators:

• The age-adjusted lung cancer incidence rate of 32.8 per 100,000 during 2003-2007 among Hispanic New Yorkers was the lowest of any other race/ethnic group and below both New York State’s Prevention Agenda objectives for this indicator (62.0 per 100,000 among males and 41.0 per 100,000 among females). Hispanic residents of New York City and Hispanic residents of New York State outside New York City experienced similar age-adjusted lung cancer incidence rates (32.4 per 100,000 and 34.7 per 100,000, respectively). Due to the small number of lung cancer cases for this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

• During 2003-2007, the age-adjusted breast cancer mortality rate among Hispanic women (16.2 per 100,000) was lower than among White non-Hispanic (23.9 per 100,000) and Black non-Hispanic (29.7 per 100,000) women and well below New York State’s Prevention Agenda objective of 21.3 per 100,000. Rates among New York City Hispanic female residents (16.1 per 100,000) were similar to the rates among Hispanic female residents of New York State excluding New York City (17.0 per 100,000). Due to the small number of deaths from breast cancer for this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

• During 2006-2008, New York State Hispanics, had a low age-adjusted mortality rate for cerebrovascular disease (20.4 per 100,000) compared to other race/ethnic groups. Only Asian/Pacific Islander non-Hispanics had a lower rate. Both Asian/Pacific Islander non-Hispanics and Hispanics had rates that were below New York State’s Prevention Agenda objective of 24.0 per 100,000 for cerebrovascular disease mortality.

• Hispanics who lived in New York City had a lower age-adjusted cerebrovascular mortality rate than their counterparts living in New York State excluding New York City (19.1 per 100,000 vs. 26.2 per 100,000).

• Among counties with a population of at least 5,000 Hispanics, Queens County had the lowest (13.3 per 100,000) and Onondaga County had the highest (66.4 per 100,000) age-adjusted cerebrovascular mortality rate among Hispanics during 2006-2008.

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Challenges

Because a high percentage of Hispanics live below the poverty level, this population fared worse on numerous health indicators than other race/ethnic groups in New York State. Challenges for this population include:

• During 2006-2008, the teen pregnancy rate for Hispanic females ages 15-17 years was 66.5 per 1,000 females, which was more than 5 times the rate for White non-Hispanics and Asian/ Pacific Islander non-Hispanics and just below the rate for Black non-Hispanic teens. The rate was also well above New York State’s Prevention Agenda objective of 28.0 per 1,000 females.

• In New York City, the Hispanic teen pregnancy rate was 70.9 per 1,000 and in New York State excluding New York City the rate was 54.8 per 1,000. Among counties with a population of at least 5,000 Hispanics, Onondaga had the highest Hispanic teen pregnancy rate (94.8 per 1,000) and Putnam had the lowest rate (18.0 per 1,000).

• The Hispanic age-adjusted asthma hospitalization rate, at 35.2 per 100,000, was more than 3 times that of White non-Hispanics and Asian/Pacific Islander non-Hispanics during 2006-2008. This rate is more than double New York State’s Prevention Agenda objective of 16.7 per 10,000.

• Hispanic residents of New York City (41.5 per 10,000) had an age-adjusted asthma hospitalization rate that was more than double the rate for Hispanic residents of New York outside New York City (17.0 per 10,000).

• Among counties with a population of at least 5,000 Hispanics, Putnam had the lowest age-adjusted asthma hospitalization rate among Hispanics (7.2 per 10,000) and the Bronx had the highest (63.2 per 10,000).

• During 2006-2008, Hispanics had the second highest age-adjusted rates for both diabetes mortality (23.0 per 100,000) and diabetes hospitalizations (27.6 per 10,000) compared to other race/ethnic groups in New York State.

• New York City Hispanic residents had higher age-adjusted rates of diabetes mortality (24.9 per 100,000) and hospitalizations (30.8 per 100,000) compared to Hispanic residents of New York State excluding New York City (15.9 per 100,000 and 16.2 per 10,000, respectively).

• Among counties with a population of at least 5,000 Hispanics, Broome had the lowest age-adjusted diabetes hospitalization rate among Hispanics (5.1 per 10,000) and Schenectady (37.0 per 10,000) and Monroe (37.3 per 10,000) had the highest rates.

• The age-adjusted drug-related hospitalization rate among New York State Hispanics was 40.4 per 10,000 during 2006-2008. This rate is far from New York State’s Prevention

16

Agenda objective of 26.0 per 10,000 and the second highest rate when compared to Black non-Hispanics (61.4 per 10,000) and all other race/ethnic groups. New York City Hispanics were almost 3 times more likely to be hospitalized for a drug-related cause than Hispanics outside New York City.

• Among counties with a population of at least 5,000 Hispanics, Nassau had the lowest age-adjusted drug-related hospitalization rate among Hispanics (4.7 per 10,000) and the Bronx (90.7 per 10,000) and Erie (84.5 per 100,000) had the highest rates.

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Asian/Pacific Islander non-Hispanic New York Residents

Socio-demographic

• In New York State, the Asian/Pacific Islander non-Hispanic population was estimated to be about 1.4 million residents and accounted for 7.2% of the state’s population in 2008. The majority (73.3%) of these individuals resided in New York City.

• Among counties outside New York City, Suffolk had the largest number of Asian/Pacific Islander non-Hispanic residents (53,229). Tompkins County had the highest percentage of Asian/Pacific Islander non-Hispanic residents (10.4%).

• During 2006-2008, 12.7% of Asian* families in New York State were living in poverty, which is more than double that of White non-Hispanics (5.9%). In New York City, where the majority of this population resided, 15.3% were living in poverty.

• Among counties outside New York City with a population of at least 5,000 Asian/Pacific Islander non-Hispanic residents, Westchester (2.0%), Nassau (3.4%), and Suffolk (4.4%) had the lowest percentages of Asian* families living in poverty. Counties with the highest percentages of Asian* families living in poverty were Onondaga (17.4%) and Tompkins (17.2%).

• Median household income for New York State Asian* residents was $60,024 during 2006-2008. This was just below the median household income for White non-Hispanics ($63,254) and considerably higher than the median household income for Black non-Hispanics ($40,522) and Hispanics ($38,688).

• New York City Asian* residents had a median household income of $53,131 during 2006-2008. Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, Westchester, Rockland, and Nassau had the highest median incomes for Asian* residents (greater than $100,000). The counties with the lowest median household incomes for Asian residents were Broome ($29,526) and Tompkins ($36,848).

* Poverty and median household income indicators are presented for Asians which include both Hispanic and non-Hispanic Asians but do not include Pacific Islanders.

General Health

• In New York State during 2006-2008, Asian/Pacific Islander non-Hispanics had the lowest age-adjusted total mortality rate (336.5 per 100,000) compared to White non-Hispanic, Black non-Hispanic, and Hispanic residents. Asian/Pacific Islander non-Hispanics residing in New York outside New York City had a total mortality rate of 287 per 100,000, while Asian/Pacific Islander non-Hispanics in New York City had a mortality rate of 350 per 100,000.

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• Among Asian/Pacific Islander non-Hispanics who died in New York State during 2006-2008, 49.6% died prematurely (before the age of 75). The only group with a lower percentage of premature deaths was White non-Hispanic (33.8%). New York City Asian/Pacific Islander non-Hispanics died prematurely less often (48.1%) compared to New Yorkers outside of New York City (56.1%).

• Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, New York County had the lowest percentage of premature death among Asian/Pacific Islander non-Hispanics (34.9%) and Schenectady County had the highest (71.4%).

Strengths

Asian/Pacific Islander non-Hispanics tend to have very good health outcomes compared to other race/ethnic groups. The following represent some areas where Asian/Pacific Islander non-Hispanics had the best health outcomes:

• During 2006-2008, the teen pregnancy rate for Asian/Pacific Islander non-Hispanic females ages 15-17 years was 8.4 per 1,000 which was the lowest rate for any race/ethnic group and below New York State’s Prevention Agenda objective of 28.0 per 1,000 females. In New York City, the Asian/Pacific Islander non-Hispanic teen pregnancy rate was 10.7 per 1,000 and in New York State outside New York City, the rate was 2.7 per 1,000. Due to the small number of teen pregnancies in this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

• Asian/Pacific Islander non-Hispanic New Yorkers had the lowest age-adjusted rates of unintentional injury mortality (10.8 per 100,000) and unintentional injury hospitalizations (28.1 per 10,000) compared to all other race/ethnic groups during 2006-2008. These rates were also below the New York State Prevention Agenda objectives (17.1 per 100,000 and 44.5 per 10,000, respectively). Rates were similarly low whether Asian/Pacific Islander non-Hispanics lived in or outside New York City.

• Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, Monroe (44.4 per 10,000) had the highest rate of unintentional injury hospitalizations among Asian/Pacific Islander non-Hispanics and Tompkins (10.3 per 10,000) had the lowest rate.

• The age-adjusted asthma-related hospitalization rate among New York State Asian/Pacific Islander non-Hispanics was 7.8 per 10,000 during 2006-2008. This rate is far below New York State’s Prevention Agenda objective of 16.7 per 10,000 and below the rates for all other race/ethnic groups.

• During 2006-2008, Asian/Pacific Islander non-Hispanic residents of New York City had an age-adjusted asthma hospitalization rate (8.6 per 10,000) that was still below New

19

York State’s Prevention Agenda objective, but higher than the rate for Asian/Pacific Islander non-Hispanics living outside New York City (5.4 per 10,000).

• Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, Albany (1.7 per 10,000) and Schenectady (1.8 per 10,000) counties had the lowest rates of age-adjusted asthma hospitalizations among Asian/Pacific Islander non-Hispanics. Bronx County’s rate among Asian/Pacific Islander non-Hispanics was the highest at 16.2 per 10,000.

• During 2003-2007, the age-adjusted female breast cancer mortality rate for Asian/Pacific Islander non-Hispanics (11.0 per 100,000) was nearly three times lower than the rate for Black non-Hispanics (29.7 per 100,000), who had the highest rate. The rate for Asian/Pacific Islander non-Hispanics was also below the Prevention Agenda objective of 21.3 per 100,000 and lower than all other race/ethnic groups.

• Asian/Pacific Islander non-Hispanics residing in New York City had an age-adjusted female breast cancer mortality rate of 10.7 per 100,000 while Asian/Pacific Islander non-Hispanic residents of New York State excluding New York City had an age-adjusted mortality rate of 12.3 per 100,000. Due to the small number of breast cancer deaths in this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

• During 2006-2008, Asian/Pacific Islander non-Hispanics had the lowest age-adjusted rates of cerebrovascular disease mortality (16.8 per 100,000) and cerebrovascular hospitalizations (13.9 per 10,000) compared to all other race/ethnic groups. Asian/Pacific Islander non-Hispanics in New York City had a slightly higher age-adjusted hospitalization rate than their counterparts living outside New York City (14.8 per 10,000 vs. 10.3 per 10,000). For age-adjusted rates of cerebrovascular mortality, however, residents of New York State outside New York City had slightly higher rates (19.0 per 100,000 vs. 16.3 per 100,000).

• Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, Rockland had the lowest age-adjusted cerebrovascular hospitalization rate among this group (5.4 per 10,000) and Monroe had the highest (25.8 per 10,000) rate.

Challenges

Even though Asian/Pacific Islander non-Hispanic health outcomes were generally better than those of other race/ethnic groups in New York State, there were health indicators where this group faced challenges:

• Early prenatal care was an area of concern for the Asian/Pacific Islander non-Hispanic population. About 71% of Asian/Pacific Islander non-Hispanic mothers giving birth statewide during 2006-2008 received early prenatal care. This was below the percentage

20

for White non-Hispanic mothers (81.1%) and New York State’s Prevention Agenda objective of 90%.

• A higher percentage of Asian/Pacific Islander non-Hispanic women residing in New York State outside New York City received early prenatal care (74.9%) compared to their New York City counterparts (69.7%). Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, Nassau and Dutchess had the highest rates of early prenatal care among Asian/Pacific Islander non-Hispanic women (81.2% and 80.1%, respectively). Counties with the lowest rates for this time period were Broome (64.6%), Orange (66.4%), and Erie (67.5%).

• Infants born weighing less than 2,500 grams are considered low birth weight and are at risk for developing health-related problems during their first year of life. Among Asian/Pacific Islander non-Hispanics, 7.8% of infants born during 2006-2008 were low birth weight. This is higher than the rate for White non-Hispanic infants (6.9%) and higher than New York State’s Prevention Agenda objective of 5.0%.

• During 2006-2008, 7.7% of Asian/Pacific Islander non-Hispanic infants born to New York City residents weighed less than 2,500 grams. In New York State excluding New York City, 8.0% of Asian/Pacific Islander non-Hispanic births were low birth weight.

• Among counties with a population of at least 5,000 Asian/Pacific Islander non-Hispanics, Monroe (4.8%), Onondaga (4.2%), and Tompkins (4.0%) had the lowest rates of low birth weight among Asian/Pacific Islander non-Hispanics, and Schenectady (10.8%), the Bronx (10.7%), and Rockland (10.4%) had the highest rates.

• Asian/Pacific Islander non-Hispanics had the second-highest age-adjusted suicide mortality rate (4.3 per 100,000) compared to all other race/ethnic groups in New York State during 2006-2008. The rate, however, was still below New York State’s Prevention Agenda objective of 4.8 per 100,000. Asian/Pacific Islander non-Hispanics New Yorkers outside New York City (3.2 per 100,000) had a lower rate than Asian/Pacific Islander non-Hispanics in New York City (4.6 per 100,000). Due to the small number of suicides in this race/ethnic group, comparisons among counties may not be meaningful. Rates derived from a small number of occurrences can fluctuate widely because of one or two events.

References

1Indian Health Service, Division of Program Statistics. Adjusting for Miscoding of Indian Race on State Death Certificates, November 1996.

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Format of the Report

The 2010 Minority Health Surveillance Report-County Edition contains information at state and

county levels across a wide range of health-related indicators as well as information on

population estimates, household income, and families living in poverty. Many of the indicators in

this report are being used to measure progress toward achieving the state’s Prevention Agenda

2013 objectives. A list of indicators with New York State Prevention Agenda objectives are

presented in a table on Page 159. A detailed description of the sources of data used in this report

is contained in Appendix 1.

Most indicators contained in this report are presented by county for the following race/ethnic

groups: White non-Hispanic, Black non-Hispanic, Asian/Pacific Islander non-Hispanic, and

Hispanic. Two exceptions, median household income and the percentage of families below

poverty, are presented by county for White non-Hispanic, Black, Asian, and Hispanic race/ethnic

groups.

Population data are presented for the year 2008. All non-cancer-related birth, death, and

hospitalization based indicators are presented for the three-year period (2006-2008). Cancer

related indicators are presented for the five-year period (2003-2007).

Hospitalization based indicators use primary diagnosis unless otherwise specified. Mortality

indicators are based on underlying causes of death.

Misclassification of race and ethnicity information on birth, death and especially hospital records

can occur during the data collection process. Please use caution when interpreting these data.

The following table presents indicators used in this report with a description of data sources and

definitions.

22

About Minority Health Data and Statistics

Indicator Data Source Definition Population National Center for

Health Statistics, Bridged Race Population Estimates

County population estimates are reported for the following groups: White non-Hispanic, Black non-Hispanic, Asian non-Hispanic, and Hispanic. The total county population estimate includes "Other" and unknown races.

Percentage of population

National Center for Health Statistics, Bridged Race Population Estimates

The percentage of the county population from each race/ethnicity category.

Median household income

U.S. Census Bureau, American Community Survey - 3 year estimates

Median household income is the income level at which half of households have incomes above the amount and half have incomes below the amount.

Percentage of families below poverty

U.S. Census, American Community Survey - 3 year estimates

The percentage of families living below the federally determined guidelines for poverty.

Total mortality rate per 100,000, age-adjusted*

Vital Records The number of deaths per 100,000 population.

Percentage premature deaths (< age 75 years)

Vital Records The percentage of all deaths that were among persons aged less than 75 years.

Years of potential life lost per 100,000, age-adjusted*

Vital Records Total years of life lost before age 75 years per 100,000 population (calculated by subtracting the ages of those who died from 75).

Births (three-year average)

Vital Records The average number of births over the latest 3-year period for each race/ethnicity group. The average number of births in the total category for each county includes "Other" and Unknown races.

Percentage of births with early (first trimester) prenatal care

Vital Records The percentage of births to women with known prenatal care who began prenatal care within the first three months of pregnancy (first trimester).

Percentage adequate prenatal care (Kotelchuk Index**)

Vital Records The percentage is based on the Kotelchuk Index**. Births to women who began care in the first trimester and have completed at least 80% of the expected prenatal visits are considered to have had adequate care.

Percentage of premature births (less than 37 weeks)

Vital Records The percentage of live births with known gestational age that were born before 37 weeks gestation.

Percentage of low birthweight births

Vital Records The percentage of births with known birthweight that resulted in infants weighing less than 2,500 grams.

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Teen (ages 15-17 Vital Records Pregnancies are the sum of the number of live births, induced years) pregnancy rate terminations of pregnancies, and all fetal deaths. Pregnancy per 1,000 rates are the number of pregnancies in the 15-17 year age

group per 1,000 females15-17 years of age. NOTE: Pregnancy data for Essex and Hamilton counties were combined for confidentiality purposes.

Fertility rate per 1,000 Vital Records The number of total live births per 1,000 female population aged 15-44.

Infant mortality rate per 1,000

Vital Records The number of deaths at less than 1 year of age per 1,000 live births.

Motor vehicle-related Vital Records The number of deaths due to motor vehicle-related causes mortality per 100,000, (ICD-10 codes: V02-V04, V09.0, V09.2, V12-V14, V19.0-age-adjusted* V19.2, V19.4-V19.6, V20-V79, V80.3-V80.5, V81.0-V81.1,

V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V888, V89.0, and V89.2) per 100,000 population.

Unintentional mortality rate per 100,000, age-adjusted*

The number of deaths due to unintentional injury (ICD-10 codes: V01-X59, Y85-Y86) per 100,000 population.

Unintentional injury, Statewide The number of hospitalizations due to unintentional injury poisoning and fall Planning and (ICD-9 CM codes: E800-E928, (excluding E870-E879)) per hospitalization rates Research 100,000 population. per 10,000, age- Cooperative adjusted* System

(SPARCS) The number of hospitalizations due to falls (ICD-9 CM codes: E880-E888, (excluding E887) per 100,000 population.

The number of hospitalizations due to poisoning ( ICD-9 CM codes: E850.0-E850.9, E852.0-E855.9, E858.0-E866.9, E868.0-E869.9, E9500-E9529, E9620-E9629, E9800-E9829, E851, E856, E857, E867, E972).

Asthma hospitalization rate per 100,000, age-specific and total, age-adjusted*

Chronic obstructive pulmonary disease (COPD) hospitalization rate among adults 18+ per 10,000

Statewide Planning and Research Cooperative System (SPARCS)

The number of hospitalizations due to asthma (ICD-9 CM code: 493) in a particular age group per 10,000 population in that age group.

The number of hospitalizations due to chronic obstructive pulmonary disease (COPD) (ICD-9 CM codes 490-494,496) among adults ages 18 or older per 100,000 adults.

Chronic lower Vital Records The number of deaths due to chronic lower respiratory respiratory disease disease CLRD (ICD-10 codes: 40-J47) among adults ages 18 (CLRD) mortality rate or older per 100,000 adults. This is a Prevention Quality among adults (18+) Indicator (PQI), a condition for which good outpatient care per 100,000 can potentially prevent the need for hospitalization or for

which early intervention can prevent complications or more severe disease.

Diseases of the heart Vital Records The number of deaths due to diseases of the heart (ICD-10 mortality rate per codes: I00-I09, I11, I13, and I20-I51) per 100,000 100,000, age- population. adjusted*

24


Diseases of the heart Statewide The number of hospitalizations due to diseases of the heart hospitalization rate per Planning and (ICD-9 CM codes: 390-398,402, and 404-429) per 10,000 10,000, age-adjusted* Research

Cooperative System (SPARCS)

population.

Cerebrovascular Vital Records The number of deaths due to cerebrovascular disease (ICD-10 disease (stroke) mortality rate per 100,000, age-adjusted*

codes: I60-I69) per 100,000 population.

Cerebrovascular Statewide The number of hospitalizations due to cerebrovascular disease disease (stroke) Planning and (ICD-9 CM codes: 430-438) per 10,000 population. hospitalization rate per Research 10,000, age-adjusted* Cooperative

System (SPARCS)

Coronary heart Vital Records The number of deaths due to coronary heart disease (ICD-10 disease mortality rate per 100,000, age-adjusted*

codes: I11, I20-I25) per 100,000 population.

Coronary heart disease hospitalization rate per 10,000, age-adjusted*


The number of hospitalizations due to coronary heart disease (ICD-9 CM codes: 402, 410-414, and 429) per 10,000 population.

Congestive heart Vital Records The number of deaths due to congestive heart failure (ICD-10 failure mortality rate per 100,000, age-adjusted*

code: I50) per 100,000 population.

Congestive heart failure hospitalization rate per 10,000, age-adjusted*


The number of hospitalizations due to congestive heart failure (ICD-9 CM code: 428) per 10,000 population.

Diabetes mortality rate Vital Records The number of deaths due to diabetes (ICD-10 codes: E10-per 100,000 population, age- adjusted*

E14) per 100,000 population.

Diabetes hospitalization rate per 10,000 (primary diagnosis), age-adjusted*


The number of hospitalizations due to diabetes (ICD 9 CM code: 250) per 10,000 population.

Diabetes hospitalization rate per 10,000 (any diagnosis), age-adjusted*


The number of hospitalizations due to diabetes (ICD 9 CM code: 250) per 10,000 population. Includes hospitalizations with diabetes mentioned in any diagnosis.

25


Diabetes short-term complications hospitalization rate among persons aged 6-18 and 18+ per 10,000


The number of hospitalizations due to short term complications of diabetes (ICD 9 CM codes: 250.1-250.3) among age group of interest per 10,000 in age group of interest. This is a Prevention Quality Indicator (PQI), a condition for which good outpatient care can potentially prevent the need for hospitalization or for which early intervention can prevent complications or more severe disease.

Lung cancer incidence rate per 100,000, age-adjusted*

New York State Cancer Registry

Incidence data are based on reports from hospitals and other health facilities that diagnose and treat cancer patients. All primary tumors receive an ICD-O-3 code indicating the anatomic site of origin. Standard Site Analysis categories for cancer data analysis are available on the SEER Incidence Site Recode web page (http://seer.cancer.gov/siterecode/). These data include only invasive malignant tumors. Data are presented for a five-year time period.

Colorectal cancer New York State The number of deaths due colorectal cancer (ICD 10 codes: mortality rate per 100,000, age-adjusted*

Cancer Registry C18-C21) per 100,000 population.

Breast cancer New York State The number of deaths due to breast cancer (ICD 10 code: mortality rate per 100,000, age-adjusted*

Cancer Registry C50) per 100,000 population.

Cervical cancer New York State The number of deaths due to cervical cancer (ICD 10 code: mortality rate per 100,000, age-adjusted*

Cancer Registry C53) per 100,000.

Percentage of cancer cases with an early stage diagnosis – (breast, cervical and colorectal)


Stage at diagnosis data are based on reports from hospitals and other health facilities that diagnose and treat cancer patients. Early stage is defined as invasive cancers that are limited to the tissue of origin. Patients for whom stage at diagnosis is unknown are not included in the calculation of percentage of cancers diagnosed at an early stage.

Drug-related hospitalizations per 10,000, age-adjusted*


The number of hospitalizations due to a drug related diagnosis (ICD-9 CM codes: 292, 304, 305.1-305.9, 648.3, 655.5, 763.5, 779.4, 779.5, 965.0, 967.0, 968.5, 969.6, 969.7, 760.70, 760.72, 760.73, 760.75, 760.79, E850-E858, E950.0-E950.2, E962.0, E980.0-E980.2) per 10,000 population.

Suicide mortality rate per 100,000, age-adjusted*

Vital Records The number of deaths due to suicide (ICD-10 codes: X60-X84, Y87.0) per 100,000 population.

*Age-adjusted Indicators

The standard population used for age adjustment was the 2000 US population.

**Kotelchuk Index

The Kotelchuk Index is a calculation based on the number of prenatal care visits received by pregnant

women ages 15-44 who had a live birth during the reporting year, expressed as a percentage of

observed-to-expected number of prenatal visits. Adequate prenatal care is defined as completion of

greater than 80% of expected visits, based on their timing of entry to prenatal care.

26

Health Indicator

Non-Hispanic

Hispanic Total White Black Asian/Pacific

Islander

Socio-Demographic Indicators Population (2008) 11,799,671 2,965,921 1,399,307 3,250,038 19,490,297

Percent of Population 60.5% 15.2% 7.2% 16.7% 100.0%

Median Annual Household Income in US Dollars (2006-08) *

63,254 40,522 60,024 38,688 55,401

Percent of Families Below Poverty (2006-08) * 5.9% 18.4% 12.7% 22.1% 10.5%

General Health Indicators Total Mortality per 100,000, Age-adjusted 689.4 795.7 336.5 533.5 684.0

Percent Premature Deaths (< 75 Years) 33.8% 60.7% 49.6% 60.5% 40.0%

Years of Potential Life Lost per 100,000, Age-adjusted 5,063 9,035 2,328 5,066 5,570

Birth-Related Indicators Number of Births per Year (3 Year Average) 122,529 41,085 22,020 59,903 250,500

Percent Births with Early (1st Trimester) Prenatal Care

81.1% 63.5% 70.8% 65.9% 73.4%

Percent Adequate Prenatal Care (Kotelchuck Index) 72.0% 51.7% 60.7% 55.6% 63.5%

Percent Premature Births (< 37 Weeks Gestation) 10.8% 16.8% 10.4% 13.1% 12.4%

Percent Low Birthweight Births (< 2.5 Kg) 6.9% 12.8% 7.8% 7.8% 8.2%

Teen (Age 15-17) Pregnancy Rate per 1,000 12.7 69.0 8.4 66.5 34.7

Total Pregnancy Rate per 1,000 Age 15-44 Females 68.6 135.0 54.8 127.1 95.5

Fertility Rate per 1,000 (All Births/Female Population 15-44)

53.9 58.9 65.6 79.2 61.4

Infant Mortality per 1,000 Live Births 4.4 11.2 2.3 4.6 5.5

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted

8.1 5.4 3.8 5.3 7.0

Unintentional Injury Mortality per 100,000, Age-adjusted

25.9 20.2 10.8 18.9 23.4

Unintentional Injury Hospitalizations per 10,000, Age-adjusted

63.1 63.4 28.1 48.6 65.8

Poisoning Hospitalizations per 10,000, Age-adjusted 9.2 15.7 3.0 9.0 10.6

Fall Hospitalizations per 10,000, Age 65+ Years 223.2 101.4 82.2 103.4 201.9

Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 9.4 44.3 7.8 35.2 20.6

Asthma Hospitalizations per 10,000, Age 0-17 Years 11.2 58.6 13.0 38.9 29.4

CLRD/COPD Mortality per 100,000, 18+ Years 60.0 22.9 7.5 12.9 43.7

COPD/CLRD Hospitalizations per 10,000, 18+ Years 36.3 57.2 9.8 38.3 40.5

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted

225.6 268.1 116.8 175.7 225.1

Diseases of the Heart Hospitalizations per 10,000, Age-adjusted

110.2 145.5 57.1 106.1 122.3

Cerebrovascular Disease (Stroke) Mortality per 100,000, Age-adjusted

27.5 31.9 16.8 20.4 27.6

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Cerebrovascular Disease (Stroke) Hospitalizations per 10,000, Age-adjusted

23.1 36.4 13.9 21.5 25.9

Coronary Heart Disease Mortality per 100,000, Age-adjusted

182.1 236.4 107.0 157.6 185.7

Coronary Heart Disease Hospitalizations per 10,000, Age-adjusted

48.8 51.2 30.5 48.6 54.1

Congestive Heart Failure Mortality per 100,000, 18+ Years

25.6 8.7 1.8 4.7 18.3

Congestive Heart Failure Hospitalizations per 10,000, Age 18+ Years

44.2 63.3 11.0 28.0 44.6

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 14.1 35.1 10.7 23.0 17.4

Diabetes Hospitalizations per 10,000 (Primary Dx ICD9 250), Age-adjusted

11.7 48.4 9.3 27.6 19.9

Diabetes Hospitalizations per 10,000 (Any Dx ICD9 250), Age-adjusted

171.2 391.0 121.9 281.8 227.4

Diabetes Short-term Complications Hospitalizations per 10,000, Age 6-18 Years

2.5 4.9 0.8 3.5 3.4

Diabetes Short-term Complications Hospitalizations per 10,000, Age 18+ Years

3.3 13.3 1.3 5.5 5.4

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07)

70.7 57.3 39.0 32.8 64.0

Colorectal Cancer Mortality per 100,000, Age-adjusted (2003-07)

17.1 21.3 11.1 13.6 17.1

Female Breast Cancer Mortality per 100,000, Age-adjusted (2003-07)

23.9 29.7 11.0 16.2 23.5

Cervix Uteri Cancer Mortality per 100,000, Age-adjusted (2003-07)

1.9 4.9 2.0 3.3 2.5

Percent Early Stage Colorectal Cancer (2003-07) 43.5% 39.3% 39.5% 36.5% 42.3%

Percent Early Stage Female Breast Cancer (2003-07) 64.9% 52.5% 63.3% 57.1% 62.7%

Percent Early Stage Cervical Cancer (2003-07) 50.7% 40.5% 51.3% 50.4% 48.4%

Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted

21.2 61.4 3.6 40.4 31.4

Suicide Mortality per 100,000, Age-adjusted 8.3 3.6 4.3 4.1 6.8

Key

Symbol Meaning s Total suppressed for confidentiality

~ Fewer than 20 events in the numerator; therefore the rate is unstable

* Hispanics are not excluded from the Black and Asian/Pacific Islander categories. Pacific Islanders are not included in the Asian/Pacific Islander category

Questions or comments: [email protected] Revised: December 2010

28

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 2,993,135 2,002,222 1,025,468 2,313,399 8,363,710



69,184 40,244 53,131 34,954 50,403






Percent Births with Early (1st Trimester) Prenatal Care 81.9% 64.7% 69.7% 68.3% 71.5%







56.3 59.5 71.0 73.5 64.5



4.2 4.3 4.0 3.9 4.2

Unintentional Injury Mortality per 100,000, Age-adjusted 18.3 18.1 10.9 17.2 17.5


60.5 64.0 29.2 47.4 64.6








258.0 274.9 123.5 184.7 244.3


100.9 143.1 61.4 105.4 126.2


14.6 27.7 16.3 19.1 19.0

29


18.9 34.4 14.8 21.0 25.3


241.5 252.0 115.1 169.3 226.7


47.1 50.8 33.0 48.4 57.5


11.6 7.3 1.6 4.7 7.7


41.3 66.2 12.5 31.8 45.7



11.8 49.9 10.3 30.8 27.8


155.3 383.3 131.6 294.9 268.3


1.6 5.4 0.7 3.9 3.9


2.3 12.9 1.4 6.2 6.5


59.2 52.3 42.5 32.4 51.0


16.7 20.7 12.1 14.3 16.9


24.8 29.6 10.7 16.1 23.3


1.9 5.2 2.0 3.5 3.1




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 24.2 69.0 3.6 49.1 43.5


Key





30

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 8,806,536 963,699 373,839 936,639 11,126,587













53.0 57.7 51.1 94.1 58.8



9.5 7.7 3.4 8.8 9.1



64.5 61.6 23.5 52.9 66.5








213.2 248.5 91.0 138.8 212.8


114.4 149.1 41.2 106.7 119.7


32.7 44.3 19.0 26.2 33.3


24.8 41.1 10.3 23.2 26.3


158.8 192.6 75.8 109.8 158.8

31


49.7 51.1 21.3 47.8 51.9


30.5 11.7 2.3~ 4.5 26.2


45.4 56.1 6.4 17.4 43.8



11.8 43.9 5.6 16.2 14.5


178.3 405.1 84.8 229.5 199.8


2.8 4.2 1.0~ 2.4 3.0


3.7 14.1 1.1 3.7 4.6


74.8 70.6 26.3 34.7 72.5


17.3 22.8 7.4 10.7 17.3


23.6 29.9 12.3 17.0 23.6


1.9 4.0 1.7~ 2.5 2.1






Key





32

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 237,202 35,925 12,284 11,999 298,130


Median Annual Household Income in US Dollars (2006-08) * 61,417 34,986 71,801 40,354 56,568

Percent of Families Below Poverty (2006-08) * 4.0% 23.6% s 19.4% 6.6%




Birth-Related Indicators Number of Births per Year (3 Year Average) 2,010 574 212 238 3,161





Teen (Age 15-17) Pregnancy Rate per 1,000 10.7 53.1 s 52.6 22.0


Fertility Rate per 1,000 (All Births/Female Population 15-44) 40.6 61.3 56.3 72.0 47.8

Infant Mortality per 1,000 Live Births 4.0 22.1 7.9~ 8.4~ 8.3

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 7.1 7.1~ s 17.1~ 7.4

Unintentional Injury Mortality per 100,000, Age-adjusted 23.2 23.5 s 39.1~ 23.5

Unintentional Injury Hospitalizations per 10,000, Age-adjusted 60.8 67.8 19.2 21.0 63.1

Poisoning Hospitalizations per 10,000, Age-adjusted 8.2 18.7 s 3.7~ 9.3

Fall Hospitalizations per 10,000, Age 65+ Years 254.6 118.0 72.2~ 45.0~ 246.2

Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 7.8 40.0 1.7~ 15.7 12.6

Asthma Hospitalizations per 10,000, Age 0-17 Years 7.7 40.1 5.8~ 16.5~ 16.2

CLRD/COPD Mortality per 100,000, 18+ Years 74.0 24.4~ 14.2~ s 64.0

COPD/CLRD Hospitalizations per 10,000, 18+ Years 36.7 63.0 1.5~ 12.9 38.1

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 219.3 224.6 73.8~ 229.0 220.6


86.6 158.0 34.7 52.4 94.8


32.4 51.4 35.5~ 29.1~ 34.2


23.2 48.0 6.1~ 14.2 25.5

Coronary Heart Disease Mortality per 100,000, Age-adjusted 148.7 162.2 70.3~ 173.8 150.4


30.0 43.3 18.5 13.4 32.9

33

Congestive Heart Failure Mortality per 100,000, 18+ Years 35.8 8.1~ 0.0~ 12.6~ 30.7


35.9 54.5 1.5~ 9.0 36.2

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 13.7 38.8 20.0~ 33.5~ 15.9


11.2 49.3 s 13.1 14.9


162.9 484.4 71.2 142.8 195.4


2.4 8.7 0.0~ s 3.7


3.5 18.1 0.0~ 3.8~ 5.0

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 78.0 78.1 20.8~ 46.3~ 77.0


15.4 24.1 s s 15.7


23.2 20.9~ s s 22.9


1.8~ s s s 1.9~

Percent Early Stage Colorectal Cancer (2003-07) 44.3% 33.3%~ s s 43.2%

Percent Early Stage Female Breast Cancer (2003-07) 65.1% 56.5% 58.3%~ 75.0%~ 64.6%

Percent Early Stage Cervical Cancer (2003-07) 53.3%~ 54.6%~ s s 54.6%

Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 17.0 45.1 0.6~ 55.4 21.3

Suicide Mortality per 100,000, Age-adjusted 8.6 7.1~ 24.3~ s 8.6

Key





34

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 47,776 580 541 613 49,649


Median Annual Household Income in US Dollars (2006-08) * 40,827 s 74,511 s 41,000

Percent of Families Below Poverty (2006-08) * 11.7% s s s 11.4%

General Health Indicators Total Mortality per 100,000, Age-adjusted 772.9 1220.~ 340.5~ 734.3~ 768.8

Percent Premature Deaths (< 75 Years) 40.8% 62.5%~ s s 40.9%

Years of Potential Life Lost per 100,000, Age-adjusted 6,940 9,519~ s s 6,847

Birth-Related Indicators Number of Births per Year (3 Year Average) 502 1 3 7 517

Percent Births with Early (1st Trimester) Prenatal Care 80.6% 100.0~ 70.0%~ 63.2%~ 80.5%

Percent Adequate Prenatal Care (Kotelchuck Index) 75.1% s 50.0%~ 70.6%~ 74.9%

Percent Premature Births (< 37 Weeks Gestation) 9.4% s 0.0%~ s 9.3%

Percent Low Birthweight Births (< 2.5 Kg) 7.2% 0.0%~ 0.0%~ 0.0%~ 7.0%

Teen (Age 15-17) Pregnancy Rate per 1,000 16.1 0.0~ 0.0~ 0.0~ 16.3

Total Pregnancy Rate per 1,000 Age 15-44 Females 58.0 15.2~ 10.2~ 48.5 57.6

Fertility Rate per 1,000 (All Births/Female Population 15-44) 49.0 7.6~ 20.3~ 40.4 48.0

Infant Mortality per 1,000 Live Births 6.6~ 0.0~ 0.0~ 0.0~ 6.4~

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 16.4 0.0~ 0.0~ 0.0~ 16.7

Unintentional Injury Mortality per 100,000, Age-adjusted 39.3 0.0~ 0.0~ 0.0~ 38.9

Unintentional Injury Hospitalizations per 10,000, Age-adjusted 67.1 38.9~ s 285.9 69.5

Poisoning Hospitalizations per 10,000, Age-adjusted 8.6 26.9~ 0.0~ 0.0~ 8.7

Fall Hospitalizations per 10,000, Age 65+ Years 200.2 0.0~ s 341.9~ 199.9

Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 10.9 32.0~ s 0.0~ 10.9

Asthma Hospitalizations per 10,000, Age 0-17 Years 14.8 s 0.0~ 0.0~ 14.6

CLRD/COPD Mortality per 100,000, 18+ Years 75.3 0.0~ s s 74.1

COPD/CLRD Hospitalizations per 10,000, 18+ Years 44.5 s s s 43.4

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 204.5 485.4~ 0.0~ s 203.8

Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 138.6 179.8~ 0.0~ 1101.7 147.4


42.1 0.0~ 0.0~ 0.0~ 41.2


23.5 51.2~ 0.0~ 155.3~ 24.6

Coronary Heart Disease Mortality per 100,000, Age-adjusted 149.3 485.4~ 0.0~ s 149.8


66.7 114.8~ 0.0~ 640.9 72.5


35


46.2 s 0.0~ 50.3~ 45.7

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 23.3 0.0~ 0.0~ 0.0~ 22.8


17.9 117.5~ 0.0~ 57.3~ 18.5


222.8 583.3 32.8~ 1143.8 231.0


1.5~ 0.0~ 0.0~ 120.5~ 2.9~


5.9 28.1~ 0.0~ 0.0~ 6.1

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 79.0 s s s 78.4


20.7 s s s 20.5


20.7 s s s 21.1


6.1~ s s s 6.0~

Percent Early Stage Colorectal Cancer (2003-07) 39.6% s s s 39.5%

Percent Early Stage Female Breast Cancer (2003-07) 64.3% s s s 63.9%

Percent Early Stage Cervical Cancer (2003-07) s s s s s

Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 11.2 57.9~ 0.0~ 0.0~ 12.0

Suicide Mortality per 100,000, Age-adjusted 16.1 0.0~ 0.0~ 0.0~ 15.5

Key





36

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 179,372 437,507 50,390 719,596 1,391,903







Birth-Related Indicators Number of Births per Year (3 Year Average) 1,601 7,155 824 12,980 22,808








Infant Mortality per 1,000 Live Births 8.3 9.0 2.0~ 5.0 6.4

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 6.9 2.8 5.4~ 3.5 3.8

Unintentional Injury Mortality per 100,000, Age-adjusted 29.3 17.4 11.1~ 19.1 19.9


74.5 69.9 28.6 62.6 81.2





CLRD/COPD Mortality per 100,000, 18+ Years 66.7 25.9 7.1~ 17.8 27.7


Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 270.7 268.9 86.8 200.1 246.8


116.2 135.5 58.3 129.2 150.0


17.7 28.6 16.7~ 21.5 23.2


20.9 33.6 13.4 26.4 31.2

Coronary Heart Disease Mortality per 100,000, Age-adjusted 248.6 242.0 85.4 182.1 225.0


52.8 42.1 33.2 53.6 60.3

37

Congestive Heart Failure Mortality per 100,000, 18+ Years 25.3 9.0 0.0~ 5.8 9.7


71.5 65.3 12.7 42.4 61.9

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 21.9 41.7 16.6~ 36.3 32.4


18.5 52.6 10.9 43.7 47.3


210.7 408.9 137.9 406.4 413.2


3.5 3.7 0.0~ 5.5 5.7


3.5 14.6 2.1 8.4 11.4

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 70.7 62.9 36.4 36.0 53.8


20.2 23.4 9.1~ 16.3 19.1


29.1 30.8 11.1~ 16.1 24.0


2.4~ 6.7 s 3.9 4.4

Percent Early Stage Colorectal Cancer (2003-07) 45.4% 41.7% 30.8%~ 38.6% 42.0%


Percent Early Stage Cervical Cancer (2003-07) 51.0% 40.8% 72.7%~ 53.2% 48.5%


Suicide Mortality per 100,000, Age-adjusted 10.5 3.4 3.2~ 4.8 5.2

Key





38

Health Indicator

Non-Hispanic


Islander






Percent Premature Deaths (< 75 Years) 35.0% 78.1% 70.8%~ 79.1% 36.4%

Years of Potential Life Lost per 100,000, Age-adjusted 6,816 12,304 2,978~ 7,646 7,047





Percent Low Birthweight Births (< 2.5 Kg) 7.5% 13.4% 7.5%~ 8.9% 8.2%

Teen (Age 15-17) Pregnancy Rate per 1,000 17.9 48.8 0.0~ 69.9 25.3



Infant Mortality per 1,000 Live Births 7.9 26.0~ 14.1~ 11.1~ 9.5

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 8.9 s 0.0~ 0.0~ 8.1

Unintentional Injury Mortality per 100,000, Age-adjusted 29.3 8.5~ 0.0~ s 28.0

Unintentional Injury Hospitalizations per 10,000, Age-adjusted 61.8 51.3 17.4~ 13.8~ 66.4

Poisoning Hospitalizations per 10,000, Age-adjusted 9.1 16.6 3.4~ 4.5~ 10.4

Fall Hospitalizations per 10,000, Age 65+ Years 223.2 71.4~ 37.3~ s 237.7

Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 8.5 26.2 5.5~ 9.9~ 10.2

Asthma Hospitalizations per 10,000, Age 0-17 Years 8.1 30.9 s 0.0~ 11.3

CLRD/COPD Mortality per 100,000, 18+ Years 81.7 s s 0.0~ 74.6

COPD/CLRD Hospitalizations per 10,000, 18+ Years 36.4 27.3 3.4~ 9.4~ 36.7

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 218.1 279.6 77.3~ 138.9~ 219.2


82.8 130.2 14.9~ 40.3 92.3


36.8 72.1~ 58.0~ 0.0~ 37.1


21.8 30.1 9.3~ 11.9~ 24.4

Coronary Heart Disease Mortality per 100,000, Age-adjusted 161.0 188.5~ 69.0~ 69.1~ 161.2


33.7 44.5 6.3~ 12.5~ 38.2

39

Congestive Heart Failure Mortality per 100,000, 18+ Years 31.0 0.0~ 0.0~ s 28.4


40.9 34.2 2.9~ 4.7~ 41.9

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 23.2 20.4~ s 71.4~ 23.6


11.9 44.2 3.8~ 5.1~ 14.0


170.7 363.2 60.2 89.3 191.9


5.0 6.3~ 0.0~ s 5.5


4.0 15.9 s s 4.7

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 71.8 168.8 s 73.1~ 72.0


15.8 36.7~ s s 16.1


22.0 s s s 21.8


1.6~ s s s 1.5~


Percent Early Stage Female Breast Cancer (2003-07) 63.6% 80.0%~ s s 64.0%

Percent Early Stage Cervical Cancer (2003-07) 64.1% s s s 63.4%


Suicide Mortality per 100,000, Age-adjusted 12.0 s 0.0~ 0.0~ 11.5

Key





40

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 74,434 1,206 528 995 79,688




General Health Indicators Total Mortality per 100,000, Age-adjusted 793.9 689.1~ s 513.6~ 799.2

Percent Premature Deaths (< 75 Years) 39.2% 76.5%~ 0.0%~ 75.0%~ 40.5%

Years of Potential Life Lost per 100,000, Age-adjusted 6,497 12,355~ 0~ 7,452~ 6,964

Birth-Related Indicators Number of Births per Year (3 Year Average) 852 9 16 18 1,014

Percent Births with Early (1st Trimester) Prenatal Care 73.9% 57.7%~ 60.9% 70.6% 73.2%

Percent Adequate Prenatal Care (Kotelchuck Index) 70.1% 57.7%~ 53.3% 58.8% 68.8%

Percent Premature Births (< 37 Weeks Gestation) 11.8% 11.1%~ 15.9%~ 27.5%~ 12.2%



Total Pregnancy Rate per 1,000 Age 15-44 Females 70.3 74.6 13.3~ 85.4 78.0


Infant Mortality per 1,000 Live Births 6.3~ s 0.0~ s 7.6



Unintentional Injury Hospitalizations per 10,000, Age-adjusted 65.2 46.6~ 34.0~ 102.0 67.2


Fall Hospitalizations per 10,000, Age 65+ Years 205.5 s s 227.3~ 205.0


Asthma Hospitalizations per 10,000, Age 0-17 Years 17.3 29.6~ 0.0~ 32.6~ 18.9

CLRD/COPD Mortality per 100,000, 18+ Years 89.8 0.0~ 0.0~ 0.0~ 85.6

COPD/CLRD Hospitalizations per 10,000, 18+ Years 55.6 33.0~ 26.2~ 43.9~ 55.6



151.5 169.6 35.5~ 325.9 157.8


32.4 0.0~ s 0.0~ 31.7


26.6 71.0~ 0.0~ s 26.9



79.3 95.8 s 170.2 82.9

41



50.0 14.1~ s 38.4~ 50.7



14.7 23.8~ 20.3~ 36.5~ 16.3


233.4 364.9 77.9~ 474.8 251.1


2.6~ 0.0~ 0.0~ 0.0~ 2.7~


5.3 18.8~ 26.2~ s 5.7



16.1 s s s 15.9


27.4 s s s 27.0


4.2~ s s s 4.1~



Percent Early Stage Cervical Cancer (2003-07) 65.0%~ s s s 65.0%~

Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 12.4 29.6~ s 35.1~ 13.7


Key





42

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 73,860 3,372 431 1,847 79,823


Median Annual Household Income in US Dollars (2006-08) * 49,696 s s 45,724 48,991


General Health Indicators Total Mortality per 100,000, Age-adjusted 729.2 944.4 0.0~ 646.8~ 728.3

Percent Premature Deaths (< 75 Years) 36.2% 67.6% 0.0%~ 40.0%~ 36.8%

Years of Potential Life Lost per 100,000, Age-adjusted 5,670 10,583 0~ 6,053~ 5,716


Percent Births with Early (1st Trimester) Prenatal Care 78.7% 55.6% 72.2%~ 67.2% 77.5%

Percent Adequate Prenatal Care (Kotelchuck Index) 78.6% 55.6% 77.8%~ 64.1% 77.3%

Percent Premature Births (< 37 Weeks Gestation) 12.1% 20.5%~ s 14.1%~ 12.3%




Fertility Rate per 1,000 (All Births/Female Population 15-44) 53.1 41.4 56.1~ 90.2 54.2




Unintentional Injury Hospitalizations per 10,000, Age-adjusted 60.0 37.4 s 52.1~ 60.0

Poisoning Hospitalizations per 10,000, Age-adjusted 11.2 9.1~ 0.0~ s 11.0

Fall Hospitalizations per 10,000, Age 65+ Years 210.8 0.0~ 0.0~ 260.4~ 209.6

Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 8.4 16.7~ s s 8.5


CLRD/COPD Mortality per 100,000, 18+ Years 82.1 s 0.0~ 0.0~ 76.7

COPD/CLRD Hospitalizations per 10,000, 18+ Years 45.4 30.2 s s 43.7

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 194.5 375.1~ 0.0~ 217.2~ 195.9


120.4 171.0 27.9~ 92.6 124.9


34.5 s 0.0~ s 35.0


24.4 22.7~ 0.0~ 15.0~ 24.7



55.5 90.9 s 32.3~ 58.8

43



38.0 12.6~ 0.0~ 21.6~ 36.4

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 15.8 104.4~ 0.0~ s 17.1


12.3 20.8~ 0.0~ 4.2~ 12.5


191.4 313.4 41.1~ 196.1 195.2


7.1 0.0~ 0.0~ 0.0~ 6.8


4.5 7.5~ 0.0~ s 4.6



17.6 s s s 17.2


17.1 s s s 17.1


s s s s s





Suicide Mortality per 100,000, Age-adjusted 8.0~ s 0.0~ 0.0~ 7.9

Key





44

Health Indicator

Non-Hispanic


Islander




Percent of Families Below Poverty (2006-08) * 10.2% s s 50.6% 12.7%

General Health Indicators Total Mortality per 100,000, Age-adjusted 783.8 947.6 0.0~ 841.4 788.1


Years of Potential Life Lost per 100,000, Age-adjusted 6,327 11,860 0~ 7,542 6,513




Percent Premature Births (< 37 Weeks Gestation) 11.7% 18.0%~ 17.2%~ 16.5% 12.3%

Percent Low Birthweight Births (< 2.5 Kg) 7.6% 13.4%~ 10.0%~ 13.3% 8.2%

Teen (Age 15-17) Pregnancy Rate per 1,000 23.7 35.4~ 0.0~ 39.8 26.5




Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 12.7 0.0~ 0.0~ s 11.8

Unintentional Injury Mortality per 100,000, Age-adjusted 30.4 s 0.0~ 45.2~ 29.8

Unintentional Injury Hospitalizations per 10,000, Age-adjusted 54.2 41.4 59.7~ 19.7 54.5



Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 10.1 19.4~ 14.0~ 10.1~ 10.3

Asthma Hospitalizations per 10,000, Age 0-17 Years 9.8 6.9~ s 6.2~ 9.9

CLRD/COPD Mortality per 100,000, 18+ Years 103.1 s 0.0~ s 96.9




71.9 149.9 54.3~ 44.8 73.8


37.0 s 0.0~ s 37.2


19.0 28.2~ 21.6~ 14.5~ 19.9



24.9 61.8 27.1~ 13.5~ 25.9

45

Congestive Heart Failure Mortality per 100,000, 18+ Years 42.3 s 0.0~ s 40.2


40.1 36.8 13.3~ 8.2~ 39.0



12.3 15.8~ 119.1 14.7 13.8


174.6 331.9 510.4 145.9 182.3


5.1 0.0~ 0.0~ s 4.6


5.5 11.5~ 116.8~ 15.9 6.7

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 68.7 180.9~ s s 68.8


16.3 s s s 16.2


23.5 s s s 23.0


s s s s s






Key





46

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 41,995 31,768 146,163 s 41,611




Years of Potential Life Lost per 100,000, Age-adjusted 6,264 9,814 1,188~ 6,012~ 6,304




Percent Premature Births (< 37 Weeks Gestation) 14.4% 24.1% s 17.2%~ 14.6%





Infant Mortality per 1,000 Live Births 5.7~ 26.1~ 0.0~ 0.0~ 6.5


Unintentional Injury Mortality per 100,000, Age-adjusted 29.8 s s 97.1~ 28.8





Asthma Hospitalizations per 10,000, Age 0-17 Years 20.8 33.6~ 0.0~ s 22.1



Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 198.0 274.7 s s 200.0


109.4 149.1 42.5~ 39.5~ 111.2


41.5 84.5~ s 0.0~ 42.8


28.7 42.7 0.0~ 30.4~ 29.3

Coronary Heart Disease Mortality per 100,000, Age-adjusted 131.2 209.4 s 0.0~ 133.2


44.8 68.1 s 6.5~ 45.7

47

Congestive Heart Failure Mortality per 100,000, 18+ Years 39.2 s 0.0~ 0.0~ 36.4


43.0 36.5 12.0~ 7.2~ 41.7

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 18.3 s 0.0~ 0.0~ 17.6


19.6 46.4 s 57.6~ 21.4


249.5 467.1 78.5 271.5 258.9


5.7 s 0.0~ 0.0~ 5.2


8.2 11.9~ 0.0~ 7.2~ 8.3

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 83.4 124.1 s s 84.1


18.9 s s s 18.6


22.6 s s s 23.2


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 27.0 66.6 s 17.6~ 29.2


Key





48

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 44,468 42,734 s 45,806 44,202


General Health Indicators Total Mortality per 100,000, Age-adjusted 830.8 379.7~ s 1586.~ 823.9

Percent Premature Deaths (< 75 Years) 38.9% s s 70.0%~ 39.1%

Years of Potential Life Lost per 100,000, Age-adjusted 6,329 s s 8,492~ 6,228


Percent Births with Early (1st Trimester) Prenatal Care 82.7% 83.3%~ 80.0%~ 64.0%~ 82.5%

Percent Adequate Prenatal Care (Kotelchuck Index) 83.6% 66.7%~ 85.7%~ 65.2%~ 83.2%

Percent Premature Births (< 37 Weeks Gestation) 8.7% s s 12.5%~ 8.7%

Percent Low Birthweight Births (< 2.5 Kg) 6.7% s s s 6.7%

Teen (Age 15-17) Pregnancy Rate per 1,000 24.6 0.0~ 0.0~ s 26.6

Total Pregnancy Rate per 1,000 Age 15-44 Females 67.3 50.3~ s 67.1 69.3





Unintentional Injury Hospitalizations per 10,000, Age-adjusted 64.0 66.0~ s 31.7~ 68.2

Poisoning Hospitalizations per 10,000, Age-adjusted 10.1 s 0.0~ s 10.7


Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 6.6 s 0.0~ s 7.6



COPD/CLRD Hospitalizations per 10,000, 18+ Years 34.7 s 0.0~ s 38.9

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 313.5 s 0.0~ 1094.~ 310.8


101.6 102.4~ s s 112.3


32.7 0.0~ 0.0~ s 33.5


19.4 50.9~ 0.0~ s 21.5

Coronary Heart Disease Mortality per 100,000, Age-adjusted 251.3 s 0.0~ 1094.~ 249.7


46.8 31.9~ 0.0~ 0.0~ 52.3

49



35.2 22.9~ 0.0~ 0.0~ 38.5



14.1 25.2~ 0.0~ s 15.8


185.2 426.5 0.0~ 62.2~ 205.4


1.7~ 0.0~ 0.0~ 0.0~ 1.7~


4.2 0.0~ 0.0~ s 5.3



17.2 s s s 16.9


21.9 s s s 22.0


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 16.0 s 0.0~ s 16.3

Suicide Mortality per 100,000, Age-adjusted 10.5~ 0.0~ 0.0~ 0.0~ 10.1~

Key





50

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 47,410 s 55,404 s 47,430


General Health Indicators Total Mortality per 100,000, Age-adjusted 758.8 671.5~ 458.4~ 786.8~ 755.4

Percent Premature Deaths (< 75 Years) 43.4% 69.2%~ s 77.8%~ 43.8%

Years of Potential Life Lost per 100,000, Age-adjusted 5,882 6,876~ s 4,276~ 5,779


Percent Births with Early (1st Trimester) Prenatal Care 87.8% 76.9%~ 73.3%~ 77.8% 87.3%

Percent Adequate Prenatal Care (Kotelchuck Index) 84.0% 84.6%~ 53.3%~ 75.0% 83.5%


Percent Low Birthweight Births (< 2.5 Kg) 6.9% s 0.0%~ 8.3%~ 6.8%

Teen (Age 15-17) Pregnancy Rate per 1,000 19.1 s 0.0~ s 18.9



Infant Mortality per 1,000 Live Births 4.9~ s 0.0~ 0.0~ 5.1~



Unintentional Injury Hospitalizations per 10,000, Age-adjusted 55.9 34.3~ 58.4~ 11.4~ 55.4

Poisoning Hospitalizations per 10,000, Age-adjusted 12.2 14.6~ s 4.1~ 12.1

Fall Hospitalizations per 10,000, Age 65+ Years 205.0 s 357.1~ 0.0~ 204.7




COPD/CLRD Hospitalizations per 10,000, 18+ Years 59.4 14.4~ s 6.9~ 55.6

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 194.0 136.0~ s 0.0~ 193.1

Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 125.3 128.2 s 30.5~ 124.5


33.4 0.0~ 0.0~ 0.0~ 32.7


22.5 18.1~ s 1.3~ 22.6

Coronary Heart Disease Mortality per 100,000, Age-adjusted 136.1 s s 0.0~ 134.8


46.5 28.6~ 0.0~ 15.4~ 46.1


51


44.0 13.1~ 0.0~ 0.0~ 41.0

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 13.1 s s 0.0~ 13.6


14.0 29.5~ s 12.0~ 14.2


236.5 396.6 127.8~ 70.3 236.6


s 0.0~ 0.0~ 0.0~ s


5.0 9.1~ 0.0~ s 5.0



14.7 s s s 14.4


17.6 s s s 17.8


s s s s s






Key





52

Health Indicator

Non-Hispanic


Islander












Percent Low Birthweight Births (< 2.5 Kg) 8.1% 11.7%~ s 3.3%~ 7.8%





Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 10.5~ 0.0~ 0.0~ 0.0~ 9.4~

Unintentional Injury Mortality per 100,000, Age-adjusted 31.0 s 0.0~ s 29.9





Asthma Hospitalizations per 10,000, Age 0-17 Years 5.1~ 28.3~ 0.0~ s 7.2


COPD/CLRD Hospitalizations per 10,000, 18+ Years 36.7 39.3 s 13.2~ 36.0

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 213.7 291.8 s 94.4~ 215.5


102.2 166.1 21.2~ 89.0 106.4


38.8 0.0~ s s 38.0


22.1 36.7 s 15.8~ 23.1

Coronary Heart Disease Mortality per 100,000, Age-adjusted 167.7 253.1~ s 94.4~ 170.0


39.5 68.0 17.4~ 18.7~ 41.8

53



45.3 68.8 0.0~ 40.6~ 45.8



8.9 46.8 s s 10.1


164.6 466.9 146.8~ 166.7 178.1


2.5~ s 0.0~ 0.0~ 2.5~


3.9 13.4~ 0.0~ 0.0~ 4.3



15.4 s s s 15.4


13.8 s s s 14.6


s s s s s



Percent Early Stage Cervical Cancer (2003-07) s s s s 42.1%~

Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 18.5 27.4 0.0~ 8.8~ 18.3


Key





54

Health Indicator

Non-Hispanic


Islander











Percent Premature Births (< 37 Weeks Gestation) 10.3% 25.0%~ s s 10.3%









Poisoning Hospitalizations per 10,000, Age-adjusted 10.6 s s 17.8~ 10.6





COPD/CLRD Hospitalizations per 10,000, 18+ Years 60.1 31.0~ s s 59.1

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 209.8 s 0.0~ s 208.9


121.8 79.2~ s 79.1~ 128.1


43.3 s 0.0~ 0.0~ 43.1


26.2 33.9~ s 0.0~ 26.8

Coronary Heart Disease Mortality per 100,000, Age-adjusted 142.8 s 0.0~ s 142.3


51.2 26.0~ 0.0~ 28.9~ 55.3

55



42.5 s 0.0~ s 42.0



11.0 45.1~ 0.0~ 0.0~ 11.2


228.1 468.7 s 104.6~ 232.6


s 0.0~ 0.0~ 0.0~ s


3.4 s 0.0~ 0.0~ 3.4



23.2 s s s 23.3


23.6 s s s 23.3


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 8.9 s s 21.3~ 9.1


Key





56

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 43,371 805 382 1,347 46,085








Percent Births with Early (1st Trimester) Prenatal Care 79.6% 46.2%~ 100.0~ 58.7% 78.3%


Percent Premature Births (< 37 Weeks Gestation) 10.4% s 0.0%~ 19.6%~ 10.5%


Teen (Age 15-17) Pregnancy Rate per 1,000 15.3 s 0.0~ 0.0~ 16.2












COPD/CLRD Hospitalizations per 10,000, 18+ Years 58.8 24.8~ 0.0~ 168.5 61.1



105.5 110.3~ s 244.4 111.2


38.3 0.0~ 0.0~ s 38.3


19.7 18.0~ 0.0~ 36.0~ 20.7



44.7 41.1~ s 37.0~ 47.4

57



56.7 31.0~ 0.0~ 95.4 58.1

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 32.6 s 0.0~ s 32.6


9.6 25.8~ s 39.8~ 10.5


171.0 362.7 19.6~ 952.6 187.0


2.2~ 0.0~ 0.0~ 0.0~ 2.0~


4.3 12.6~ s 0.0~ 4.6



19.8 s s s 19.4


19.8 s s s 20.5


s s s s s





Suicide Mortality per 100,000, Age-adjusted 8.3~ s 0.0~ 0.0~ 8.7~

Key





58

Health Indicator

Non-Hispanic


Islander




















Poisoning Hospitalizations per 10,000, Age-adjusted 8.8 10.8 s 4.1 8.5

Fall Hospitalizations per 10,000, Age 65+ Years 202.3 103.3 42.2~ 70.9 194.5


Asthma Hospitalizations per 10,000, Age 0-17 Years 16.4 42.3 7.0~ 14.6 20.7

CLRD/COPD Mortality per 100,000, 18+ Years 64.1 22.3~ s 14.6~ 54.2




93.9 117.7 25.9 53.4 97.2


28.8 65.0 34.0~ 17.5~ 30.9


27.3 46.0 7.6~ 12.8 28.7



35.0 38.5 12.4 23.4 36.6

59

Congestive Heart Failure Mortality per 100,000, 18+ Years 21.5 12.8~ s 5.5~ 18.8


41.2 37.1 4.0~ 6.8 37.8



10.8 39.3 1.6~ 13.1 13.5


176.4 413.4 57.5 162.8 196.5


3.6 4.0~ 0.0~ 2.0~ 3.6


2.7 9.7 s 3.3~ 3.3



17.5 21.0~ s s 17.3


23.1 44.7 s s 23.6


1.8~ s s s 1.7~



Percent Early Stage Cervical Cancer (2003-07) 42.5%~ s s s 47.1%


Suicide Mortality per 100,000, Age-adjusted 9.0 s s 4.8~ 8.0

Key





60

Health Indicator

Non-Hispanic


Islander








Birth-Related Indicators Number of Births per Year (3 Year Average) 6,684 1,907 310 658 9,889









Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 6.8 7.3 s 3.9~ 7.0

Unintentional Injury Mortality per 100,000, Age-adjusted 21.4 25.7 17.1~ 25.2~ 22.3






CLRD/COPD Mortality per 100,000, 18+ Years 72.2 37.7 s 19.4~ 65.0




104.2 158.1 30.1 130.9 112.1


40.1 62.6 32.8~ 30.2~ 42.2


26.2 43.2 9.8 26.4 28.4



45.3 50.7 17.4 56.0 46.9

Congestive Heart Failure Mortality per 100,000, 18+ Years 43.0 19.8 0.0~ 7.5~ 38.0

61


47.3 77.8 4.0~ 33.4 50.1

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 17.1 40.1 11.8~ 30.2~ 19.7


11.4 48.3 4.5~ 25.9 16.2


160.3 412.1 72.0 354.3 194.1


4.5 3.6 s 7.6~ 4.5


4.0 21.0 s 6.6 6.2

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 74.7 93.5 22.3~ 52.8 75.8


16.6 25.1 s 11.7~ 17.2


27.6 36.5 s s 28.0


1.5 3.7~ s s 1.8

Percent Early Stage Colorectal Cancer (2003-07) 44.1% 42.9% s 50.0%~ 44.0%


Percent Early Stage Cervical Cancer (2003-07) 61.3% 42.9%~ s s 56.7%


Suicide Mortality per 100,000, Age-adjusted 8.5 5.6 s 7.9~ 8.1

Key





62

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 44,853 30,000 s s 44,466





Birth-Related Indicators [Essex & Hamilton] Number of Births per Year (3 Year Average) 381 1 3 5 398

Percent Births with Early (1st Trimester) Prenatal Care 75.6% s 62.5%~ 61.5%~ 75.1%



Percent Low Birthweight Births (< 2.5 Kg) 8.1% s 0.0%~ s 8.2%


Total Pregnancy Rate per 1,000 Age 15-44 Females 62.1 s 0.0~ 56.7~ 62.7

Fertility Rate per 1,000 (All Births/Female Population 15-44) 50.9 s 37.6~ 46.7~ 51.5





Poisoning Hospitalizations per 10,000, Age-adjusted 10.8 s 0.0~ 0.0~ 10.1


Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 7.1 s 0.0~ 0.0~ 7.1

Asthma Hospitalizations per 10,000, Age 0-17 Years 6.8~ 0.0~ 0.0~ 0.0~ 6.5~


COPD/CLRD Hospitalizations per 10,000, 18+ Years 43.3 s 0.0~ s 41.2


Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 92.5 112.4~ 0.0~ 16.2~ 94.4


40.7 s 0.0~ 0.0~ 40.8


19.5 s 0.0~ 0.0~ 19.4



33.4 25.5~ 0.0~ 13.6~ 34.4


63


50.0 13.4~ 0.0~ 0.0~ 47.6



10.7 s 0.0~ 0.0~ 11.1


145.1 315.6 0.0~ 14.8~ 147.3


3.4~ 0.0~ 0.0~ 0.0~ 4.0~


2.3 0.0~ 0.0~ 0.0~ 2.2



19.6 s s s 19.4


9.0~ s s s 10.3~


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 12.6 s 0.0~ 0.0~ 11.6


Key





64

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 40,132 s 200,000+ s 39,802



Percent Premature Deaths (< 75 Years) 42.4% 83.3%~ 0.0%~ 100.0~ 43.4%



Percent Births with Early (1st Trimester) Prenatal Care 68.8% s 78.3% 52.4%~ 68.6%

Percent Adequate Prenatal Care (Kotelchuck Index) 68.7% s 80.4% 66.7%~ 68.4%


Percent Low Birthweight Births (< 2.5 Kg) 7.0% 0.0%~ s s 6.8%



Fertility Rate per 1,000 (All Births/Female Population 15-44) 59.2 17.1~ 307.2 57.4 59.5








Asthma Hospitalizations per 10,000, Age 0-17 Years 6.8~ 0.0~ 0.0~ 0.0~ 7.0



Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 199.0 s s 0.0~ 193.9

Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 109.7 107.8 s 10.7~ 111.8


27.7 0.0~ 0.0~ 0.0~ 26.4


23.3 12.3~ s 0.0~ 23.8

Coronary Heart Disease Mortality per 100,000, Age-adjusted 137.8 s s 0.0~ 134.6


46.2 71.0~ 0.0~ 0.0~ 48.6


65


39.2 2.2~ s 0.0~ 34.6



16.2 10.6~ s 0.0~ 16.8


230.0 232.6 111.8~ 15.2~ 233.7


4.0~ 0.0~ 0.0~ 0.0~ 3.5~


5.4 6.6~ 0.0~ 0.0~ 5.6



19.2 s s s 18.8


17.0 s s s 16.8


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 20.2 0.8~ 0.0~ s 18.0

Suicide Mortality per 100,000, Age-adjusted 9.5~ 0.0~ 0.0~ s 8.6~

Key





66

Health Indicator

Non-Hispanic


Islander












Percent Low Birthweight Births (< 2.5 Kg) 8.2% s 0.0%~ 13.7%~ 8.4%









Fall Hospitalizations per 10,000, Age 65+ Years 228.1 s 0.0~ s 225.3







118.0 74.9~ s 78.5~ 117.2


26.7 0.0~ 0.0~ 0.0~ 26.2


28.7 31.7~ 0.0~ 0.0~ 29.1



51.9 29.4~ s 31.9~ 51.6

67



41.1 33.4~ 0.0~ s 40.1



15.2 20.2~ 0.0~ 31.3~ 15.1


225.7 218.9 56.8~ 205.9 227.4


11.5 0.0~ 0.0~ 0.0~ 10.6


2.9 0.0~ 0.0~ 0.0~ 2.8



22.3 s s s 21.9


28.6 s s s 28.6


s s s s s






Key





68

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 779.1 1101.0 s s 788.0

Percent Premature Deaths (< 75 Years) 33.3% 60.0% s s 34.3%

Years of Potential Life Lost per 100,000, Age-adjusted 5,804 17,150 s s 6,087







Total Pregnancy Rate per 1,000 Age 15-44 Females 72.1 72.9 s 133.9 76.2






Poisoning Hospitalizations per 10,000, Age-adjusted 8.9 7.7~ s 59.0 10.3





COPD/CLRD Hospitalizations per 10,000, 18+ Years 53.4 59.3 s s 52.9


Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 134.8 155.8 s 1714.7 146.7


35.3 s 0.0~ 0.0~ 35.4


21.2 31.9~ 0.0~ 175.7~ 22.3



62.9 87.4 s 867.5 69.8


69


53.9 20.8~ 0.0~ 81.2 53.7



10.0 89.4 s 53.5~ 12.1


211.3 511.0 64.5~ 1710.4 229.4


3.1~ 0.0~ 0.0~ 0.0~ 2.9~


3.4 50.4~ 0.0~ s 4.8



17.1 s s s 17.0


22.3 s s s 22.7


s s s s s






Key





70

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 849.4 1172.1 s 817.5 854.3

Percent Premature Deaths (< 75 Years) 40.3% 66.7% s 77.4% 41.8%

Years of Potential Life Lost per 100,000, Age-adjusted 6,644 16,215 s 13,437 6,844









Infant Mortality per 1,000 Live Births s s 0.0~ 0.0~ s












108.4 156.9 s 57.4 111.5


33.0 153.0~ 0.0~ 0.0~ 34.5


26.4 87.5 0.0~ 9.8~ 28.0



44.4 42.2~ 0.0~ 28.5~ 45.6

71



46.6 29.5 0.0~ 16.7~ 44.3

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 9.8~ s 0.0~ s 11.2


10.5 35.2 0.0~ 12.0~ 12.0


188.3 453.5 93.2~ 205.2 199.0


s 0.0~ 0.0~ s 1.4~


2.8 6.0~ 0.0~ s 3.3



22.4 s s s 23.7


24.1 s s s 24.8


s s s s s





Suicide Mortality per 100,000, Age-adjusted 11.7~ s 0.0~ s 11.9~

Key





72

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * s s s s s

Percent of Families Below Poverty (2006-08) * s s s s s

General Health Indicators Total Mortality per 100,000, Age-adjusted 769.9 s 0.0~ s 770.8

Percent Premature Deaths (< 75 Years) 40.9% s 0.0%~ s 41.8%

Years of Potential Life Lost per 100,000, Age-adjusted 6,223 s 0~ s 6,138

Birth-Related Indicators [Hamilton & Essex] Number of Births per Year (3 Year Average) 381 1 3 5 398






Total Pregnancy Rate per 1,000 Age 15-44 Females 62.1 s 0.0~ 56.7~ 62.7



Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted s 0.0~ 0.0~ 0.0~ s

Unintentional Injury Mortality per 100,000, Age-adjusted 49.5~ 0.0~ 0.0~ 0.0~ 48.2~


Poisoning Hospitalizations per 10,000, Age-adjusted 6.7~ s 0.0~ 0.0~ 6.9~


Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 6.3~ 0.0~ 0.0~ 0.0~ 6.1~

Asthma Hospitalizations per 10,000, Age 0-17 Years s 0.0~ 0.0~ 0.0~ s

CLRD/COPD Mortality per 100,000, 18+ Years 40.4~ 0.0~ 0.0~ 0.0~ 39.4~




97.8 0.0~ 0.0~ 0.0~ 97.7


31.8~ 0.0~ 0.0~ 0.0~ 31.5~


21.3 0.0~ 0.0~ 0.0~ 21.4



43.1 0.0~ 0.0~ 0.0~ 42.7

73

Congestive Heart Failure Mortality per 100,000, 18+ Years 40.4~ 0.0~ 0.0~ 0.0~ 39.4~


33.1 0.0~ 0.0~ 0.0~ 33.1

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 11.8~ 0.0~ 0.0~ 0.0~ 11.7~


6.5~ 0.0~ 0.0~ 0.0~ 6.3~


136.5 0.0~ 0.0~ 0.0~ 137.2


s 0.0~ 0.0~ 0.0~ s


s 0.0~ 0.0~ 0.0~ s



16.9~ s s s 21.1~


s s s s s


s s s s s

Percent Early Stage Colorectal Cancer (2003-07) 40.9%~ s s s 40.9%~

Percent Early Stage Female Breast Cancer (2003-07) 79.2%~ s s s 79.2%~


Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 12.2~ 440.2~ 0.0~ s 16.7


Key





74

Health Indicator

Non-Hispanic


Islander












Percent Low Birthweight Births (< 2.5 Kg) 6.5% s s 5.9%~ 6.8%













COPD/CLRD Hospitalizations per 10,000, 18+ Years 43.2 47.8~ 0.0~ s 42.6


Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 128.5 131.1~ s 157.4 129.1


29.7 0.0~ 0.0~ 0.0~ 29.3


25.5 0.0~ 0.0~ 36.5~ 25.8



52.0 22.6~ 0.0~ 64.2~ 52.2


75


66.4 39.9~ 0.0~ 27.9~ 65.3



16.2 s 0.0~ 29.1~ 16.1


226.5 520.2 39.3~ 175.8 227.6


4.9~ 0.0~ 0.0~ 0.0~ 5.0~


4.5 0.0~ 0.0~ s 4.4



15.8 s s s 15.8


18.0 s s s 18.3


s s s s s






Key





76

Health Indicator

Non-Hispanic


Islander











Percent Premature Births (< 37 Weeks Gestation) 10.6% 18.8% 11.2%~ 10.4% 11.1%











Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 7.1 28.0 s 7.5~ 7.3






114.3 117.2 17.3~ 231.4 118.3


44.2 s s 0.0~ 44.1


19.0 14.2~ s 11.2~ 19.1



58.9 41.2 s 78.9~ 61.8

77



28.4 5.5~ s 11.3~ 26.1



10.5 34.2 0.0~ 27.9~ 10.6


196.9 296.8 58.2~ 402.3 200.3


4.3 0.0~ 0.0~ 0.0~ 3.7


4.0 7.1~ 0.0~ s 4.0



18.1 s s s 17.9


22.7 s s s 22.9


s s s s 2.2~






Key





78

Health Indicator

Non-Hispanic


Islander

















Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 4.8 3.9 3.6 4.4 4.5



54.3 60.7 30.0 41.6 61.1









107.2 151.3 78.5 113.1 141.3


10.3 26.6 11.0 20.1 16.6


18.3 35.2 18.6 20.4 26.5



53.7 57.8 39.4 59.3 67.9

79



47.0 66.8 20.1 30.1 53.0



12.9 52.0 16.2 30.9 31.3


168.6 386.5 179.3 295.3 289.4


1.1 6.9 1.4~ 4.1 4.4


2.6 12.8 2.8 5.8 7.4



16.8 19.8 13.2 17.6 17.9


22.0 29.6 9.1 20.2 23.9


1.9 5.2 2.4~ 3.2 3.2



Percent Early Stage Cervical Cancer (2003-07) 50.0% 36.7% 48.7%~ 50.5% 43.0%



Key





80

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 42,472 s s s 42,201


General Health Indicators Total Mortality per 100,000, Age-adjusted 742.2 s 1969.~ s 741.8

Percent Premature Deaths (< 75 Years) 38.5% s 100.0~ s 39.0%

Years of Potential Life Lost per 100,000, Age-adjusted 6,200 s 10,643~ s 6,316


Percent Births with Early (1st Trimester) Prenatal Care 76.4% 100.0~ s 66.7%~ 76.1%

Percent Adequate Prenatal Care (Kotelchuck Index) 74.3% 100.0~ s 55.6%~ 73.9%




Total Pregnancy Rate per 1,000 Age 15-44 Females 67.6 23.5~ 52.6~ 57.8~ 71.0

Fertility Rate per 1,000 (All Births/Female Population 15-44) 60.0 18.8~ s 44.4~ 60.6




Unintentional Injury Hospitalizations per 10,000, Age-adjusted 60.8 38.7~ 0.0~ s 61.1




Asthma Hospitalizations per 10,000, Age 0-17 Years 5.1~ s 0.0~ 0.0~ 6.0~



Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 186.2 s 0.0~ 0.0~ 185.4

Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 140.8 338.4~ s 269.4~ 142.9


31.6 0.0~ 0.0~ 0.0~ 31.3


26.0 0.0~ 0.0~ 135.6~ 26.1



65.3 s 0.0~ 0.0~ 65.7


81


41.9 62.5~ 0.0~ 74.1~ 42.2



15.7 0.0~ 0.0~ 0.0~ 15.4


231.7 s s 358.5~ 232.0


3.3~ 0.0~ 0.0~ 0.0~ 3.2~


6.0 0.0~ 0.0~ 0.0~ 5.9



18.3 s s s 18.2


18.3~ s s s 18.2~


s s s s s





Suicide Mortality per 100,000, Age-adjusted 9.3~ 0.0~ s 0.0~ 10.4~

Key





82

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 756.4 825.8 s 641.2~ 752.9







Percent Low Birthweight Births (< 2.5 Kg) 6.3% 0.0%~ 0.0%~ s 6.1%







Unintentional Injury Hospitalizations per 10,000, Age-adjusted 56.8 42.9~ s 641.9 64.0

Poisoning Hospitalizations per 10,000, Age-adjusted 7.8 s s 65.9 9.4

Fall Hospitalizations per 10,000, Age 65+ Years 191.7 s s 1916.7 203.2






Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 123.1 115.8 41.1~ 1622.3 135.9


39.3 0.0~ 0.0~ 0.0~ 38.2


22.7 24.3~ s 389.9 25.8



52.3 51.1 30.6~ 779.3 59.2


83


33.2 17.6~ 0.0~ 79.2 33.9



8.8 34.6~ s 82.5~ 10.2


178.5 295.8 207.5~ 2314.4 198.0


2.0~ 0.0~ 0.0~ s 2.7~


3.3 s s s 3.5



18.0 s s s 19.2


19.7 s s s 19.8


s s s s s






Key





84

Health Indicator

Non-Hispanic


Islander






Percent Premature Deaths (< 75 Years) 39.3% s s s 39.7%

Years of Potential Life Lost per 100,000, Age-adjusted 5,380 s s s 5,362




Percent Premature Births (< 37 Weeks Gestation) 11.2% s 14.3%~ s 11.2%


















42.3 0.0~ s s 43.5


24.2 s 0.0~ s 24.5

Coronary Heart Disease Mortality per 100,000, Age-adjusted 118.5 s 0.0~ 0.0~ 118.1


50.6 11.7~ 0.0~ 21.1~ 51.9


85


26.9 s 0.0~ 0.0~ 26.1



10.1 33.0~ 0.0~ 0.0~ 10.3


171.3 236.0 s 101.9~ 174.2


2.0~ 0.0~ 0.0~ 0.0~ 1.9~


4.4 s 0.0~ 0.0~ 4.3



23.5 s s s 23.5


25.2 s s s 25.4


s s s s s






Key





86

Health Indicator

Non-Hispanic


Islander








Birth-Related Indicators Number of Births per Year (3 Year Average) 5,446 1,959 326 834 8,757








Infant Mortality per 1,000 Live Births 4.3 16.3 s 11.2 7.7








CLRD/COPD Mortality per 100,000, 18+ Years 53.6 22.4 s 18.4~ 46.5




96.6 154.0 94.2 355.4 111.7


35.0 58.8 28.4~ 29.6~ 37.0


20.4 41.8 25.8 71.6 24.3



39.6 44.1 39.4 133.2 43.9

87

Congestive Heart Failure Mortality per 100,000, 18+ Years 39.4 11.0 s 12.3~ 33.4


41.0 63.7 22.4 59.6 44.5

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 11.6 38.2 s 26.6~ 13.9


8.4 46.0 14.2 37.3 14.6


143.1 430.9 204.4 675.5 193.6


1.6 3.2 6.0~ 6.0~ 2.6


3.1 20.0 4.0 10.9 5.8



16.7 26.2 18.8~ 9.3~ 17.3


22.2 25.7 s s 21.8


1.3 2.8~ s s 1.4

Percent Early Stage Colorectal Cancer (2003-07) 47.7% 42.9% 40.6%~ 33.3%~ 46.9%





Key





88

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 815.4 780.9~ s 894.7 818.9

Percent Premature Deaths (< 75 Years) 30.9% 64.3%~ s 73.6% 32.4%

Years of Potential Life Lost per 100,000, Age-adjusted 6,559 13,171~ s 10,117 6,895




Percent Premature Births (< 37 Weeks Gestation) 10.9% 0.0%~ s 11.5% 10.9%





Infant Mortality per 1,000 Live Births 5.9~ s 0.0~ s 5.4~






Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 10.6 16.3~ 0.0~ 33.5 12.2



COPD/CLRD Hospitalizations per 10,000, 18+ Years 55.0 12.8~ 0.0~ 61.6 54.5

Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 305.0 334.4~ s 368.7 308.0


154.4 240.9 0.0~ 180.1 158.9


27.6 s 0.0~ 82.3~ 28.5


32.9 38.0~ 0.0~ 26.5~ 33.3



58.8 71.9~ 0.0~ 62.9 60.5

89



83.4 110.0~ 0.0~ 59.6 81.8



16.1 32.7~ 0.0~ 39.0 17.5


255.1 568.2 682.2 520.1 278.8


5.4~ 0.0~ 0.0~ 0.0~ 4.4~


6.2 s 0.0~ 16.0~ 6.9



17.5 s s s 17.1


25.0 s s s 23.9


s s s s s






Key





90

Health Indicator

Non-Hispanic


Islander




















74.6 67.0 26.6 29.7 75.8









130.8 148.6 48.4 59.9 130.4


24.3 23.5 17.5 22.1 24.4


25.0 40.3 9.6 14.7 26.5



54.3 51.5 25.6 27.8 54.2

91



57.0 56.1 8.9 10.4 49.9

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 10.9 17.0 10.4 8.3~ 11.2


11.9 44.4 8.5 8.9 15.4


171.1 398.2 98.4 124.8 195.2


2.4 5.5 1.4~ 0.7~ 2.6


2.5 9.2 1.2 1.2 3.2



16.3 21.0 6.2 7.3 16.0


23.8 28.7 13.9 16.3 23.7


1.4 3.9~ s 2.2~ 1.6



Percent Early Stage Cervical Cancer (2003-07) 50.3% 43.2%~ s 43.8%~ 48.5%



Key





92

Health Indicator

Non-Hispanic


Islander




















56.8 88.3 30.6 51.8 64.4









74.3 160.9 45.4 116.0 105.5


17.8 30.8 23.6 21.4 21.5


15.9 33.5 13.3 21.4 21.5



29.8 50.9 19.9 50.2 42.5

93



19.3 90.0 10.5 46.8 37.1



6.8 58.6 8.8 34.4 22.7


88.9 459.4 107.9 323.7 219.7


1.4 5.6 s 3.7 3.5


1.4 16.8 1.1 8.2 5.5



14.0 25.0 15.0 12.9 15.7


26.3 32.9 11.4 15.6 23.4


1.7 6.1 1.4~ 4.6 3.0





Suicide Mortality per 100,000, Age-adjusted 7.8 4.9 3.5~ 4.7 6.3

Key





94

Health Indicator

Non-Hispanic


Islander




Percent of Families Below Poverty (2006-08) * 7.1% 37.0% s s 9.2%








Percent Low Birthweight Births (< 2.5 Kg) 7.0% 14.4% 5.6%~ 7.9%~ 7.7%









Fall Hospitalizations per 10,000, Age 65+ Years 230.0 144.7 s s 226.9

Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 10.5 31.9 s 13.2~ 12.3



COPD/CLRD Hospitalizations per 10,000, 18+ Years 58.7 71.7 s 23.6~ 58.8



152.4 265.8 31.5~ 82.3 159.3


36.6 32.6~ 0.0~ 0.0~ 36.1


31.6 53.0 10.5~ 6.8~ 32.8



73.5 102.9 19.2~ 45.5 76.0

95



64.4 112.0 6.6~ 15.3~ 66.3



19.6 81.9 0.0~ 12.3~ 23.6


228.0 588.1 47.2~ 142.3 248.4


3.2 2.8~ 0.0~ s 3.1


7.2 36.9 0.0~ 8.3~ 9.4



16.7 28.4~ s s 17.0


24.4 28.1~ s s 24.5


1.9~ s s s 2.0~




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 23.5 72.7 s 39.6 27.1

Suicide Mortality per 100,000, Age-adjusted 10.3 s s s 10.0

Key





96

Health Indicator

Non-Hispanic


Islander
















Infant Mortality per 1,000 Live Births 5.9 24.0~ s s 7.0

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 8.5 13.1~ s s 8.9

Unintentional Injury Mortality per 100,000, Age-adjusted 24.4 17.6~ s 25.6~ 24.2


Poisoning Hospitalizations per 10,000, Age-adjusted 11.2 14.4 4.3~ 7.8 11.1




CLRD/COPD Mortality per 100,000, 18+ Years 89.9 23.0~ s s 82.1




135.7 188.8 55.0 94.6 138.7


38.5 58.0~ 74.6~ 54.8~ 40.1


30.9 54.4 24.2 28.1 32.1



63.3 60.5 23.0~ 52.0 64.1

97



62.5 57.1 8.9~ 12.1 60.0

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 18.1 59.6~ s s 19.5


15.2 48.8 12.6~ 27.3 17.1


242.1 509.8 169.9 327.8 256.5


2.7 11.8~ 0.0~ 0.0~ 3.3


5.0 18.1 s 5.3~ 5.7



16.3 25.0~ s s 16.4


19.1 s s s 18.9


2.4~ s s s 2.9



Percent Early Stage Cervical Cancer (2003-07) 55.0% s s s 52.1%



Key





98

Health Indicator

Non-Hispanic


Islander
























CLRD/COPD Mortality per 100,000, 18+ Years 75.0 29.7 0.0~ s 67.2




85.7 152.3 34.1 77.2 92.7


37.2 59.5 39.5~ 66.4~ 39.2


23.0 41.0 12.1 23.7 24.7

Coronary Heart Disease Mortality per 100,000, Age-adjusted 118.1 145.1 28.3~ 124.7~ 120.2


34.2 39.8 13.0 29.1 36.0

99



37.0 63.8 3.2~ 16.4 38.5



9.5 49.8 3.8~ 22.5 12.8


155.0 488.1 70.8 254.4 183.5


2.3 9.2 0.0~ 0.0~ 3.4


3.6 17.4 1.1~ 7.4~ 5.0



16.6 21.8 s s 17.0


24.0 32.6 s s 24.4


2.2 s s s 2.2

Percent Early Stage Colorectal Cancer (2003-07) 47.1% 42.9% s s 46.8%

Percent Early Stage Female Breast Cancer (2003-07) 69.4% 60.0% s 50.0%~ 68.4%




Key





100

Health Indicator

Non-Hispanic


Islander







Years of Potential Life Lost per 100,000, Age-adjusted 5,267 8,730~ 2,202~ 6,287~ 5,361






Teen (Age 15-17) Pregnancy Rate per 1,000 11.6 38.0~ s 78.9~ 16.3



Infant Mortality per 1,000 Live Births 5.7~ s 0.0~ 16.1~ 6.5

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 10.2 s s s 10.8

Unintentional Injury Mortality per 100,000, Age-adjusted 31.8 75.5~ s s 33.1










106.2 141.9 29.3~ 717.8 117.1


39.1 0.0~ 0.0~ 0.0~ 38.1


23.5 48.3 s 95.2 24.8

Coronary Heart Disease Mortality per 100,000, Age-adjusted 121.6 82.1~ s s 120.5


45.6 47.5 s 448.7 52.5

101

Congestive Heart Failure Mortality per 100,000, 18+ Years 28.7 0.0~ s 0.0~ 27.5


35.5 47.4 s 42.2 35.9



10.3 31.4~ 0.0~ 33.9 11.5


167.8 367.2 23.8~ 782.3 180.2


1.6~ 0.0~ 0.0~ 19.8~ 2.3~


4.4 9.9~ 0.0~ 6.7~ 4.5



14.7 s s s 14.7


18.3 s s s 18.4


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 14.3 25.9~ s 26.1 14.7


Key





102

Health Indicator

Non-Hispanic


Islander








Birth-Related Indicators Number of Births per Year (3 Year Average) 3,457 421 124 1,263 5,391










Unintentional Injury Mortality per 100,000, Age-adjusted 30.4 25.6 s 19.6 28.3










136.2 177.5 44.2 78.4 140.9


34.3 42.9 s 22.8~ 34.2


28.0 46.3 9.9~ 19.2 29.3



63.1 71.1 26.5 43.3 66.2

103



42.9 48.0 3.7~ 10.4 38.8



15.4 37.5 5.6~ 13.7 17.1


230.6 476.4 78.1 199.1 250.0


1.8 s 0.0~ 2.8~ 2.2


4.9 7.8 s 2.5 4.9



20.4 24.8 s 13.7~ 20.1


26.9 29.5~ s 16.5~ 25.9


2.4~ 9.1~ s s 3.1

Percent Early Stage Colorectal Cancer (2003-07) 41.0% 33.9%~ s 42.9%~ 40.3%

Percent Early Stage Female Breast Cancer (2003-07) 57.0% 52.5% 50.0%~ 54.0% 56.5%

Percent Early Stage Cervical Cancer (2003-07) 42.6% 54.6%~ s 54.6%~ 47.1%



Key





104

Health Indicator

Non-Hispanic


Islander

















Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 14.0~ s 0.0~ 0.0~ 14.0~






Asthma Hospitalizations per 10,000, Age 0-17 Years 6.0~ s 0.0~ s 6.0~






43.1 116.8~ 0.0~ 0.0~ 44.4


26.1 68.1 0.0~ 96.0 28.5



81.7 49.9 0.0~ 94.6 82.4


105


50.9 29.0 s 19.6~ 48.2



13.9 44.1 0.0~ 15.2~ 15.1


229.7 373.4 s 399.6 238.4


2.2~ 0.0~ 0.0~ s 2.4~


6.0 8.3~ 0.0~ s 6.2



15.0 s s s 15.1


18.2 s s s 17.3


s s s s s






Key





106

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 858.0 1141.~ s 404.0~ 855.7











Infant Mortality per 1,000 Live Births 4.1~ s 0.0~ s 4.6~












136.7 107.1~ 27.7~ 105.8 144.2


42.0 s 0.0~ s 42.7


31.8 27.0~ 0.0~ 46.6~ 32.6



62.3 51.9~ s 37.5~ 66.0

107



46.2 24.5~ 0.0~ 28.3~ 47.8



16.5 37.1~ s 25.0~ 17.4


241.5 269.7 65.8~ 223.6 254.4


3.2~ 0.0~ 0.0~ 0.0~ 3.2~


6.2 s 0.0~ s 6.5



20.0 s s s 19.8


19.0 s s s 18.8


5.2~ s s s 5.2~






Key





108

Health Indicator

Non-Hispanic


Islander




























114.7 198.6 60.5~ 52.7~ 118.1


31.1 0.0~ 0.0~ s 31.3


24.1 11.9~ 18.4~ 16.2~ 24.4



47.7 62.3~ 0.0~ 25.8~ 49.8

109



47.1 38.3~ s 12.5~ 46.2



10.5 25.0~ 0.0~ 0.0~ 10.6


174.5 372.3 105.1~ 115.4 177.5


7.6~ 0.0~ 0.0~ 0.0~ 6.9~


2.9 s 0.0~ 0.0~ 2.9



17.5 s s s 17.5


21.6 s s s 21.2


s s s s s






Key





110

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 709.1 419.7~ 448.3~ 439.2 688.5

Percent Premature Deaths (< 75 Years) 40.8% 64.7%~ 45.5%~ 55.9% 41.5%

Years of Potential Life Lost per 100,000, Age-adjusted 4,376 3,552~ 1,750~ 3,278 4,162
















Asthma Hospitalizations per 10,000, Age 0-17 Years 7.9 s s 0.0~ 7.8






28.0 0.0~ 0.0~ 29.0~ 27.3


23.1 23.3~ 55.3~ 8.6~ 23.5



35.3 19.6~ 45.1~ 20.7 38.1


111


32.2 0.0~ s 6.3~ 28.8



8.7 13.4~ s 11.3 9.2


149.7 171.1 161.5 136.8 153.2


s 0.0~ 0.0~ 0.0~ s


2.0 7.1~ s 4.5~ 2.4

Cancer Indicators Lung Cancer Incidence per 100,000, Age-adjusted (2003-07) 79.0 s s 33.0~ 76.5


16.8 s s s 16.5


22.1 s s s 21.7


s s s s s


Percent Early Stage Female Breast Cancer (2003-07) 60.2% s s 78.6%~ 60.9%


Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 26.5 19.5~ 5.7~ 8.3 23.8


Key





112

Health Indicator

Non-Hispanic


Islander

















Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 4.3 6.5 4.3 3.7 4.7



64.1 50.5 28.5 31.3 57.4









107.6 125.7 61.6 65.4 113.9


15.9 26.9 15.3 13.3 18.0


19.9 33.9 14.0 15.3 23.5



50.0 46.1 35.7 33.3 55.1

113

Congestive Heart Failure Mortality per 100,000, 18+ Years 15.1 6.4 1.7 2.6 7.5


52.1 54.2 10.3 13.2 37.2



12.7 40.1 8.3 14.2 19.4


169.5 316.8 121.3 151.4 216.0


2.3 4.4 0.6~ 1.2 2.4


2.7 9.7 0.9 2.8 4.3



17.2 17.5 10.6 10.9 15.4


26.0 26.6 11.2 13.9 22.0


2.1 3.3 2.1 2.7 2.4






Key





114

Health Indicator

Non-Hispanic


Islander













Teen (Age 15-17) Pregnancy Rate per 1,000 12.1 56.7 0.0~ 44.9~ 17.7



Infant Mortality per 1,000 Live Births 3.6~ 18.5~ s 16.2~ 5.7


Unintentional Injury Mortality per 100,000, Age-adjusted 26.5 s s s 25.7










113.7 170.5 6.5~ 91.3 119.2


30.5 45.3~ 0.0~ 0.0~ 30.6


30.1 44.1 12.7~ 10.5~ 30.9



47.0 48.3 6.6~ 26.6~ 49.5

115



41.3 56.8 0.0~ 15.8~ 40.9



13.6 62.1 0.0~ 22.8~ 15.4


213.4 555.3 32.5~ 249.2 228.7


3.9 s 0.0~ 0.0~ 3.5


4.3 16.7 0.0~ 8.7~ 5.0



16.7 24.6~ s s 16.9


23.4 41.5~ s s 24.0


2.3~ s s s 2.1~






Key





116

Health Indicator

Non-Hispanic


Islander








Birth-Related Indicators Number of Births per Year (3 Year Average) 3,223 722 425 1,400 5,819










Unintentional Injury Mortality per 100,000, Age-adjusted 19.7 15.7~ 5.6~ 20.2 18.7









Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 122.3 155.8 33.7 81.5 123.4


16.7 23.3 9.1~ 14.2~ 17.0


25.1 45.8 9.4 20.9 26.4



59.2 56.7 18.2 38.6 59.7

Congestive Heart Failure Mortality per 100,000, 18+ Years 10.6 5.2~ s s 8.2

117


42.2 53.2 5.2 15.7 37.7



16.1 45.7 4.2 26.5 19.2


205.4 430.6 75.4 254.9 228.1


1.4 1.3~ 0.0~ 4.8 2.1


2.8 10.9 0.6~ 5.8 3.9



19.3 12.4~ 11.7~ 16.5 18.5


28.0 27.2 10.4~ 7.2~ 25.6


2.1 s s s 2.3



Percent Early Stage Cervical Cancer (2003-07) 47.3% s s 37.5%~ 45.1%



Key





118

Health Indicator

Non-Hispanic


Islander
















Infant Mortality per 1,000 Live Births 3.3 9.7~ s 1.7~ 3.8












86.3 90.4 25.4 60.9 86.1


34.9 40.6 12.4~ 32.2~ 35.1


21.9 37.1 5.4 15.1 23.2



36.1 29.2 13.0 24.5 35.7

119



35.1 32.4 5.5 12.7 31.3



9.0 27.1 2.2~ 15.1 11.5


150.4 321.6 73.3 197.2 173.0


1.7~ s 0.0~ 4.6~ 2.3


1.9 6.8 0.0~ 2.9 2.6



14.0 19.8 s 10.6~ 13.9


20.0 26.2 12.3~ 17.0~ 20.4


s s s s 1.5~



Percent Early Stage Cervical Cancer (2003-07) 54.2%~ 46.7%~ s s 52.1%



Key





120

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 41,722 s s 57,679 41,526




Years of Potential Life Lost per 100,000, Age-adjusted 7,116 8,003~ 4,771~ 2,575~ 6,963


Percent Births with Early (1st Trimester) Prenatal Care 78.3% 61.5%~ 78.4% 71.7% 77.8%







Infant Mortality per 1,000 Live Births 6.6 0.0~ s 0.0~ 6.4






Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 14.3 19.2~ 0.0~ s 14.3






131.5 99.0 33.5~ 42.1~ 134.9


36.9 s 0.0~ 0.0~ 36.8


27.6 30.9~ s 0.0~ 27.5



50.5 57.3~ 25.6~ 14.0~ 53.8

121



55.6 10.3~ 0.0~ s 53.0



17.6 43.5~ 0.0~ s 17.6


272.6 276.9 19.1~ 61.7~ 274.1


4.1~ 0.0~ 0.0~ 0.0~ 3.9~


5.1 5.9~ 0.0~ 0.0~ 5.0



26.2 s s s 25.8


19.6 s s s 19.9


3.7~ s s s 3.6~






Key





122

Health Indicator

Non-Hispanic


Islander
















Infant Mortality per 1,000 Live Births 3.3 0.0~ 0.0~ s 3.1

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 9.9 s s s 9.8





Respiratory Disease Indicators Asthma Hospitalizations per 10,000, Age-adjusted 8.0 18.0 0.0~ s 8.0






101.7 63.3 17.5~ 21.3~ 102.3


33.0 s 0.0~ s 32.7


24.3 17.9~ s 1.4~ 24.6



39.5 25.3~ 4.4~ s 40.2

123



32.6 16.2~ 3.7~ 5.7~ 31.6



9.3 31.8 s 0.0~ 9.4


157.3 277.7 31.0~ 39.9 158.8


3.9 0.0~ 0.0~ 0.0~ 3.6


3.0 3.6~ s 0.0~ 2.9



17.7 s s s 17.7


24.7 s s s 24.6


2.0~ s s s 1.9~





Suicide Mortality per 100,000, Age-adjusted 8.6 s s 0.0~ 8.4

Key





124

Health Indicator

Non-Hispanic


Islander


























Heart Disease and Stroke Indicators Diseases of the Heart Mortality per 100,000, Age-adjusted 196.9 269.9 63.2~ 197.2~ 199.3


109.3 110.5 16.8~ 75.5 111.9


28.9 54.7~ 0.0~ s 29.8


31.0 41.6 5.3~ 10.0~ 31.8

Coronary Heart Disease Mortality per 100,000, Age-adjusted 130.2 193.2 45.0~ 142.8~ 132.3


42.6 29.2 12.8~ 16.7~ 43.4

125



56.8 34.5 1.5~ 23.5 52.8



12.5 38.5 1.2~ 37.0 14.5


192.3 451.3 46.5 274.4 213.8


2.8~ 2.2~ 0.0~ s 2.7~


4.4 16.2 0.0~ 9.3~ 5.5



17.1 23.3~ s s 17.1


22.6 s s s 22.3


2.7~ s s s 2.4~


Percent Early Stage Female Breast Cancer (2003-07) 68.0% 50.0%~ s 75.0%~ 67.2%




Key





126

Health Indicator

Non-Hispanic


Islander






Percent Premature Deaths (< 75 Years) 37.6% s 0.0%~ 66.7%~ 38.0%

Years of Potential Life Lost per 100,000, Age-adjusted 5,340 s 0~ 20,362~ 5,570




Percent Premature Births (< 37 Weeks Gestation) 11.4% 0.0%~ 0.0%~ s 11.0%





Infant Mortality per 1,000 Live Births 3.5~ 0.0~ 0.0~ s 5.5~

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 7.1~ s 0.0~ 0.0~ 8.1~



Poisoning Hospitalizations per 10,000, Age-adjusted 15.5 0.0~ s s 15.1

Fall Hospitalizations per 10,000, Age 65+ Years 216.3 0.0~ s s 214.2


Asthma Hospitalizations per 10,000, Age 0-17 Years 10.4~ 0.0~ 0.0~ s 10.4






25.4 0.0~ 0.0~ s 25.7


24.5 0.0~ s 14.3~ 24.6



45.3 0.0~ 0.0~ 10.7~ 45.5


127


36.1 25.7~ 0.0~ 0.0~ 34.8



10.5 43.3~ 0.0~ 0.0~ 10.2


189.1 85.0~ s 95.8~ 187.2


s 0.0~ 0.0~ 0.0~ s


3.7 s 0.0~ 0.0~ 3.6



21.9 s s s 21.9


24.8 s s s 24.3


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 17.6 s s 13.8~ 17.5


Key





128

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * s s s s s

Percent of Families Below Poverty (2006-08) * s s s s s

General Health Indicators Total Mortality per 100,000, Age-adjusted 711.1 s 0.0~ 1265.~ 706.5

Percent Premature Deaths (< 75 Years) 39.2% s 0.0%~ s 39.5%

Years of Potential Life Lost per 100,000, Age-adjusted 5,441 s 0~ s 5,422


Percent Births with Early (1st Trimester) Prenatal Care 78.4% s s 83.3%~ 78.8%

Percent Adequate Prenatal Care (Kotelchuck Index) 72.9% s s 80.0%~ 72.9%



Teen (Age 15-17) Pregnancy Rate per 1,000 16.6~ 0.0~ 0.0~ 0.0~ 16.8

Total Pregnancy Rate per 1,000 Age 15-44 Females 59.4 20.0~ 0.0~ 79.7~ 59.6

Fertility Rate per 1,000 (All Births/Female Population 15-44) 50.4 s s 43.5~ 49.6



Unintentional Injury Mortality per 100,000, Age-adjusted 27.8~ 0.0~ 0.0~ 0.0~ 26.5~







COPD/CLRD Hospitalizations per 10,000, 18+ Years 47.3 s 0.0~ 0.0~ 46.9




34.1 0.0~ 0.0~ 0.0~ 33.5


24.1 s 0.0~ s 24.5



43.7 s 0.0~ s 44.6


129


45.0 0.0~ 0.0~ 0.0~ 43.5



9.2 s 0.0~ 0.0~ 10.1


189.6 190.7~ 0.0~ 168.8~ 193.9


4.8~ 0.0~ 0.0~ 0.0~ 4.5~


3.2~ 0.0~ 0.0~ 0.0~ 3.8~



25.0 s s s 24.8


12.2~ s s s 12.1~


s s s s s




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 11.1 s 0.0~ 0.0~ 11.3

Suicide Mortality per 100,000, Age-adjusted 13.2~ s 0.0~ 0.0~ 14.5~

Key





130

Health Indicator

Non-Hispanic


Islander











Percent Premature Births (< 37 Weeks Gestation) 8.7% 0.0%~ 0.0%~ s 8.4%
















Diseases of the Heart Hospitalizations per 10,000, Age-adjusted 127.1 149.4~ 0.0~ 575.2 135.1


32.1 0.0~ 0.0~ 0.0~ 31.6


23.1 39.0~ 0.0~ 169.4~ 24.2



58.9 57.1~ 0.0~ 330.9 63.1


131


46.0 6.7~ 0.0~ 12.3~ 42.7

Diabetes Indicators Diabetes Mortality per 100,000, Age-adjusted 13.1~ 0.0~ 0.0~ s 13.6~


9.0 25.3~ 0.0~ 24.0~ 9.7


174.1 320.8 s 655.8 183.2


2.2~ s 0.0~ 0.0~ 2.7~


3.5 s 0.0~ s 3.7



17.2 s s s 16.8


18.0~ s s s 17.8~


s s s s s






Key





132

Health Indicator

Non-Hispanic


Islander



















Unintentional Injury Hospitalizations per 10,000, Age-adjusted 68.2 57.9 s 249.5 70.7









112.6 122.8 29.0~ 342.9 116.1


34.4 s 0.0~ s 34.6


23.1 22.9~ s 138.2 24.1



45.0 26.1~ 14.0~ 149.8 46.8

133



49.6 65.8 s 57.2~ 49.6



14.7 48.5 s 21.9~ 15.5


205.4 339.1 14.3~ 584.4 210.0


3.2~ 26.5~ s s 4.4


6.7 s 0.0~ 0.0~ 6.6



18.3 s s s 18.3


29.7 s s s 29.4


2.3~ s s s 2.5~






Key





134

Health Indicator

Non-Hispanic


Islander

Socio-Demographic Indicators Population (2008) 1,135,340 111,990 53,229 207,326 1,512,224



88,438 67,744 90,576 66,819 84,767













54.1 55.6 50.7 117.5 65.2





76.2 67.7 22.2 65.4 76.7









148.5 168.6 37.2 115.7 150.1


29.3 42.8 15.4~ 21.1 29.7


27.7 41.9 9.0 26.3 29.1

135


184.8 210.0 62.3 101.3 180.6


69.7 63.3 19.2 50.5 70.2



48.4 61.2 4.2 20.6 45.3



12.6 44.1 3.3 17.6 15.1


186.2 400.2 61.2 230.6 205.8


2.0 3.4 s 1.5~ 2.1


3.0 13.5 0.4~ 4.1 3.9


77.3 64.8 28.9 29.5 73.0


18.9 22.7 9.2~ 13.2 18.6


25.4 33.7 17.0~ 17.4 25.3


1.8 5.1~ s 3.6~ 2.1



Percent Early Stage Cervical Cancer (2003-07) 53.1% 40.9%~ s 55.0% 52.9%


Suicide Mortality per 100,000, Age-adjusted 8.4 4.1~ s 2.0~ 7.0

Key





136

Health Indicator

Non-Hispanic


Islander




























121.5 161.8 18.0~ 95.8 131.5


27.3 s s 53.6~ 27.9


22.4 34.9 9.1~ 19.0 23.7



58.4 57.2 12.5~ 58.5 65.3

137



45.5 62.3 s 15.4 44.0



13.0 36.9 0.0~ 16.5 15.4


213.3 405.6 86.0 229.2 234.9


2.7~ 8.0~ 0.0~ 0.0~ 3.0~


5.2 13.6 0.0~ 9.3~ 6.3



19.3 s s s 17.9


18.1 s s s 18.2


3.6~ s s s 3.1~






Key





138

Health Indicator

Non-Hispanic


Islander






Percent Premature Deaths (< 75 Years) 41.5% s s 75.0%~ 41.8%

Years of Potential Life Lost per 100,000, Age-adjusted 5,403 s s 16,236~ 5,382


Percent Births with Early (1st Trimester) Prenatal Care 79.5% 100.0~ 80.0%~ 62.5%~ 79.2%

Percent Adequate Prenatal Care (Kotelchuck Index) 74.9% 100.0~ 55.6%~ 46.2%~ 74.2%

Percent Premature Births (< 37 Weeks Gestation) 12.1% 75.0%~ s s 12.3%




Fertility Rate per 1,000 (All Births/Female Population 15-44) 58.5 12.6~ 28.0~ 33.3~ 57.7




Unintentional Injury Hospitalizations per 10,000, Age-adjusted 28.1 s 0.0~ 59.2~ 30.7










27.9 0.0~ 0.0~ 0.0~ 27.4


10.9 0.0~ 0.0~ 23.3~ 12.9



18.9 0.0~ s 0.0~ 19.9


139


13.1 0.0~ 0.0~ 0.0~ 14.5



4.3 0.0~ 0.0~ 0.0~ 4.5


73.7 57.6~ 0.0~ 60.5~ 81.2


0.0~ 0.0~ 0.0~ 0.0~ 0.0~


1.0~ 0.0~ 0.0~ 0.0~ 0.9~



19.5 s s s 19.5


21.5 s s s 21.7


s s s s s






Key





140

Health Indicator

Non-Hispanic


Islander




Percent of Families Below Poverty (2006-08) * 4.0% s 17.2% s 6.2%



















Asthma Hospitalizations per 10,000, Age 0-17 Years 12.3 33.8~ s 20.7~ 14.3






36.7 s 0.0~ s 36.6


18.7 33.4~ 9.9~ 16.4~ 19.2



34.4 47.5 s 53.9~ 36.1


141


23.6 21.8 s 5.0~ 20.4



5.9 21.8~ s s 6.0


131.7 367.4 30.2 141.0 135.7


2.3~ 0.0~ 0.0~ 0.0~ 2.2~


1.5 5.5~ s s 1.6



17.4 s s s 17.1


24.0 s s s 24.1


3.0~ s s s 2.9~




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 13.0 33.6 s s 12.0

Suicide Mortality per 100,000, Age-adjusted 7.8~ 0.0~ s 0.0~ 7.0

Key





142

Health Indicator

Non-Hispanic


Islander

























COPD/CLRD Hospitalizations per 10,000, 18+ Years 39.5 49.0 s 20.4 38.5



115.7 164.7 11.8~ 68.6 118.3


30.6 56.7~ 0.0~ 44.0~ 31.5


28.8 40.6 17.9~ 15.6 29.5



47.6 61.2 7.8~ 31.4 49.2

143

Congestive Heart Failure Mortality per 100,000, 18+ Years 30.6 11.7~ s s 27.3


49.5 51.6 0.0~ 10.5 46.7



12.7 54.0 4.7~ 14.4 14.7


204.4 492.6 58.5 221.7 219.6


2.5~ s 0.0~ 0.0~ 2.4~


4.2 6.7~ 0.0~ 5.2~ 4.4



20.6 17.5~ s s 20.1


27.0 35.5~ s 33.2~ 27.4


3.3~ s s s 3.2~

Percent Early Stage Colorectal Cancer (2003-07) 44.7% s s 41.2%~ 44.5%

Percent Early Stage Female Breast Cancer (2003-07) 62.4% 50.0%~ s 63.6%~ 62.1%


Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 26.9 32.7 s 11.3 25.5


Key





144

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 727.8 910.8~ 746.9~ 1218.~ 727.5

Percent Premature Deaths (< 75 Years) 38.3% 53.8%~ 80.0%~ s 38.6%

Years of Potential Life Lost per 100,000, Age-adjusted 6,348 13,158~ 3,260~ s 6,293





















110.9 60.6~ s 58.7~ 113.5


33.4 s 0.0~ s 33.6


21.9 22.6~ s 0.0~ 22.1



45.9 38.6~ 0.0~ 0.0~ 48.3

145



45.0 0.0~ 0.0~ s 43.9



14.0 27.2~ 0.0~ 6.4~ 13.9


209.9 253.9 178.7~ 156.6~ 210.1


6.3~ 0.0~ 0.0~ 43.9~ 7.0


4.2 s 0.0~ 0.0~ 4.1



18.0 s s s 17.8


22.6 s s s 23.1


3.8~ s s s 3.8~






Key





146

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 46,071 s 27,216 66,250 45,964









Percent Low Birthweight Births (< 2.5 Kg) 7.1% 0.0%~ s s 7.0%

Teen (Age 15-17) Pregnancy Rate per 1,000 22.6 s s s 22.9















106.2 139.4 s 14.9~ 110.0


29.8 0.0~ 0.0~ 0.0~ 29.3


19.0 17.2~ 0.0~ 0.0~ 19.1



45.1 64.5~ s s 48.3

147



41.7 20.6~ 0.0~ s 40.2



13.0 26.1~ 0.0~ 0.0~ 13.2


200.9 298.8 50.7~ 56.5~ 203.5


7.2~ 0.0~ 0.0~ 0.0~ 7.7


3.6 5.5~ 0.0~ 0.0~ 3.6



18.0 s s s 17.7


26.7 s s s 27.7


s s s s s






Key





148

Health Indicator

Non-Hispanic


Islander











Percent Premature Births (< 37 Weeks Gestation) 10.2% 11.1%~ s 13.8% 10.4%





Infant Mortality per 1,000 Live Births 5.4~ s 0.0~ s 6.4

Injury-Related Indicators Motor Vehicle-Related Mortality per 100,000, Age-adjusted 14.7 s 0.0~ s 14.6











130.0 158.0 106.4~ 328.1 135.9


37.1 84.7~ 0.0~ s 38.0


24.2 35.5 s 49.5 25.1



57.6 66.6 44.6~ 200.2 60.8

149



42.1 44.4 s 28.1~ 42.0



10.3 27.8 s 21.6~ 11.3


183.1 354.6 71.8~ 462.9 194.5


1.7~ 0.0~ 0.0~ 19.2~ 2.4~


4.4 7.9~ 0.0~ 0.0~ 4.5



16.5 s s s 16.4


23.9 s s s 23.1


4.2~ s s s 4.4~




Substance Abuse and Mental Health-Related Indicators Drug-related Hospitalizations per 10,000, Age-adjusted 11.7 24.3 s 20.7~ 12.6


Key





150

Health Indicator

Non-Hispanic


Islander
























CLRD/COPD Mortality per 100,000, 18+ Years 58.3 27.7 s 7.4 41.9




94.2 134.5 42.1 83.9 106.2


27.0 36.3 13.5~ 31.0 28.6


20.8 39.5 10.8 18.9 24.1



42.9 49.5 23.6 40.7 48.7

151



41.5 55.4 6.3 14.3 38.3



8.7 44.6 3.5 15.2 14.5


128.5 369.0 70.2 201.7 173.8


1.1 4.5 s 1.5~ 2.1


2.1 13.1 0.3~ 3.4 3.9



15.6 22.1 8.0~ 11.7 15.9


24.8 28.2 10.3~ 17.6 24.3


1.7 4.2~ s 2.5~ 2.0



Percent Early Stage Cervical Cancer (2003-07) 42.6% 34.0%~ s 57.1% 44.8%


Suicide Mortality per 100,000, Age-adjusted 6.3 2.2~ 3.8~ 4.0 5.4

Key





152

Health Indicator

Non-Hispanic


Islander





General Health Indicators Total Mortality per 100,000, Age-adjusted 774.8 1085.~ 0.0~ 92.5~ 763.9

Percent Premature Deaths (< 75 Years) 38.2% 75.0%~ 0.0%~ 100.0~ 38.8%



Percent Births with Early (1st Trimester) Prenatal Care 81.4% s 75.0%~ 64.7% 80.8%

Percent Adequate Prenatal Care (Kotelchuck Index) 78.9% s 75.0%~ 60.6% 78.4%





Fertility Rate per 1,000 (All Births/Female Population 15-44) 54.5 s 24.7~ 102.3 54.9














33.1 0.0~ 0.0~ 0.0~ 32.5


25.4 28.6~ 0.0~ 389.4~ 26.9



77.5 80.3 0.0~ 490.9 81.1


153


42.9 8.7~ 0.0~ 10.7~ 39.1



13.7 9.0~ 0.0~ 62.3~ 14.0


198.6 262.1 s 1353.6 204.5


4.0~ 0.0~ 0.0~ 0.0~ 3.9~


4.4 s 0.0~ 0.0~ 4.4



21.6 s s s 21.2


31.3 s s s 32.1


s s s s s





Suicide Mortality per 100,000, Age-adjusted 12.7~ 0.0~ 0.0~ s 12.9~

Key





154

Health Indicator

Non-Hispanic


Islander



Median Annual Household Income in US Dollars (2006-08) * 43,428 2,500- 70,938 48,438 43,428


General Health Indicators Total Mortality per 100,000, Age-adjusted 730.5 856.7~ s s 730.8




Percent Births with Early (1st Trimester) Prenatal Care 54.9% s 100.0~ 70.0%~ 55.3%

Percent Adequate Prenatal Care (Kotelchuck Index) 41.7% s 100.0~ 62.5%~ 42.0%




Total Pregnancy Rate per 1,000 Age 15-44 Females 70.5 35.5~ s 39.0~ 71.0














113.3 144.7~ 0.0~ 1386.6 127.5


36.1 0.0~ 0.0~ 0.0~ 35.6


26.1 73.3~ 0.0~ 141.6~ 27.3

Coronary Heart Disease Mortality per 100,000, Age-adjusted 123.9 s 0.0~ 0.0~ 123.3


50.2 102.1~ 0.0~ 804.4 59.8

155



44.6 s 0.0~ 44.3~ 44.9



10.1 0.0~ 0.0~ s 10.6


187.0 417.8~ 87.2~ 1032.8 197.5


s 0.0~ 0.0~ s 3.2~


2.9~ 0.0~ 0.0~ 0.0~ 3.0~



20.3 s s s 20.0


19.0~ s s s 18.9~


s s s s s






Key





156

157

New York State Population by County* and Race/Ethnicity, 2008

County*

Non-Hispanic

Hispanic TotalWhite Black Asian/Pacific Islander

Albany 237,202 35,925 12,284 11,999 298,130

Broome 173,280 9,119 6,932 5,221 195,018

Chemung 78,738 5,849 1,072 1,938 87,813

Dutchess 226,149 29,314 10,003 26,732 292,878

Erie 727,690 122,443 18,170 35,305 909,845

Franklin 41,554 3,204 220 2,114 50,521

Greene 42,932 2,996 397 2,515 48,992

Jefferson 103,149 6,829 1,618 5,624 118,046

Monroe 559,004 105,747 21,640 44,129 732,762

Montgomery 42,808 857 383 4,526 48,679

Nassau 931,186 148,191 97,207 172,707 1,351,625

Niagara 191,286 14,643 2,111 3,921 214,464

Oneida 203,503 14,345 3,629 9,472 231,590

Onondaga 374,483 47,524 12,104 13,977 452,633

Orange 268,688 37,744 9,496 62,599 379,647

Orleans 36,874 3,001 179 1,863 42,135

Putnam 83,705 2,739 2,138 10,535 99,244

Rensselaer 137,069 9,431 3,842 4,548 155,261

Rockland 205,281 32,745 19,300 40,504 298,545

Schenectady 123,621 14,087 6,293 6,904 151,427

Suffolk 1,135,340 111,990 53,229 207,326 1,512,224

Sullivan 58,776 6,888 1,219 9,075 76,189

Tompkins 82,191 4,147 10,478 3,958 101,136

Ulster 152,721 11,451 3,170 13,733 181,670

Westchester 576,689 132,036 57,420 186,060 953,943

Bronx 179,372 437,507 50,390 719,596 1,391,903

Kings 948,962 855,940 241,028 504,051 2,556,598

New York 818,302 227,215 184,851 400,698 1,634,795

Queens 720,834 434,047 512,047 612,873 2,293,007

Richmond 325,665 47,513 37,152 76,181 487,407

New York City 2,993,135 2,002,222 1,025,468 2,313,399 8,363,710

NYS (Excluding NYC) 8,806,536 963,699 373,839 936,639 11,126,587

New York State 11,799,671 2,965,921 1,399,307 3,250,038 19,490,297

*New York State Counties with Over Ten Percent Minority Population Data Source: 2008 National Center for Health Statistics bridged-race population estimates,

http://www.cdc.gov/nchs/nvss/bridged_race.htm

158

New York State Percent of Population by County* and Race/Ethnicity, 2008

County*

Non-Hispanic

Hispanic TotalWhite Black Asian/Pacific Islander

Albany 79.6% 12.1% 4.1% 4.0% 100.0%

Broome 88.9% 4.7% 3.6% 2.7% 100.0%

Chemung 89.7% 6.7% 1.2% 2.2% 100.0%

Dutchess 77.2% 10.0% 3.4% 9.1% 100.0%

Erie 80.0% 13.5% 2.0% 3.9% 100.0%

Franklin 82.3% 6.3% 0.4% 4.2% 100.0%

Greene 87.6% 6.1% 0.8% 5.1% 100.0%

Jefferson 87.4% 5.8% 1.4% 4.8% 100.0%

Monroe 76.3% 14.4% 3.0% 6.0% 100.0%

Montgomery 87.9% 1.8% 0.8% 9.3% 100.0%

Nassau 68.9% 11.0% 7.2% 12.8% 100.0%

Niagara 89.2% 6.8% 1.0% 1.8% 100.0%

Oneida 87.9% 6.2% 1.6% 4.1% 100.0%

Onondaga 82.7% 10.5% 2.7% 3.1% 100.0%

Orange 70.8% 9.9% 2.5% 16.5% 100.0%

Orleans 87.5% 7.1% 0.4% 4.4% 100.0%

Putnam 84.3% 2.8% 2.2% 10.6% 100.0%

Rensselaer 88.3% 6.1% 2.5% 2.9% 100.0%

Rockland 68.8% 11.0% 6.5% 13.6% 100.0%

Schenectady 81.6% 9.3% 4.2% 4.6% 100.0%

Suffolk 75.1% 7.4% 3.5% 13.7% 100.0%

Sullivan 77.1% 9.0% 1.6% 11.9% 100.0%

Tompkins 81.3% 4.1% 10.4% 3.9% 100.0%

Ulster 84.1% 6.3% 1.7% 7.6% 100.0%

Westchester 60.5% 13.8% 6.0% 19.5% 100.0%

Bronx 12.9% 31.4% 3.6% 51.7% 100.0%

Kings 37.1% 33.5% 9.4% 19.7% 100.0%

New York 50.1% 13.9% 11.3% 24.5% 100.0%

Queens 31.4% 18.9% 22.3% 26.7% 100.0%

Richmond 66.8% 9.7% 7.6% 15.6% 100.0%

New York City 35.8% 23.9% 12.3% 27.7% 100.0%

NYS (Excluding NYC) 79.1% 8.7% 3.4% 8.4% 100.0%

New York State 60.5% 15.2% 7.2% 16.7% 100.0%

*New York State Counties with Over Ten Percent Minority Population Data Source: 2008 National Center for Health Statistics bridged-race population estimates,

http://www.cdc.gov/nchs/nvss/bridged_race.htm

159

Minority Health Report Indicators with Prevention Agenda 2013 Objectives

Prevention Agenda Health Indicator 2013 Objective

Birth- Related Indicators

Percent Births with Early (1st Trimester) Prenatal Care 90.0%

Percent Low Birthweight Births (< 2.5 Kg) 5.0%

Teen (Age 15-17) Pregnancy Rate per 1,000 28.0 per 1,000

Infant Mortality rate per 1,000 Live Births 4.5 per 1,000

Injury- Related Indicators

Motor Vehicle-Related Mortality Rate per 100,000, Age-adjusted 5.8 per 100,000

Unintentional Injury Mortality Rate per 100,000, Age-adjusted 17.1 per 100,000

Unintentional Injury Hospitalization Rate per 10,000, Age-adjusted 44.5 per 10,000

Fall Hospitalization Rate per 10,000, Age 65+ Years 155 per 10,000

Respiratory Disease Indicators

Asthma Hospitalization Rate per 10,000, Age-adjusted 16.7 per 10,000

Asthma Hospitalization Rate per 10,000, Age 0-17 Years 17.3 per 10,000

COPD/CLRD Hospitalization Rate per 10,000, 18+ Years 31.0 per 10,000

Heart Disease and Stroke Indicators

Cerebrovascular Disease (Stroke) Mortality Rate per 100,000, Age-adjusted

24.0 per 100,000

Coronary Heart Disease Hospitalization Rate per 10,000, Age-adjusted 48.0 per 10,000

Congestive Heart Failure Hospitalization Rate per 10,000, Age 18+ Years

33.0 per 10,000

Diabetes Indicators

Diabetes Short-term Complications Hospitalization Rate per 10,000, Age 6 – 18 Years

2.3 per 10,000

Diabetes Short-term Complications Hospitalization Rate per 10,000, Age 18+ Years

3.9 per 10,000

Cancer Indicators

Lung Cancer Incidence Rate per 100,000, Age-adjusted Males – 62.0 per 100,000, Females – 41.0 per 100,000

Colorectal Cancer Mortality Rate per 100,000, Age-adjusted 13.7 per 100,000

Female Breast Cancer Mortality Rate per 100,000, Age-adjusted 21.3 per 100,000

Cervix Uteri Cancer Mortality Rate per 100,000, Age-adjusted 2.0 per 100,000

Percent Early Stage Colorectal Cancer 50%

Percent Early Stage Female Breast Cancer 80%

Percent Early Stage Cervical Cancer 65%

Substance Abuse and Mental Health Related Indicators

Drug-related Hospitalization Rate per 10,000, Age-adjusted 26.0 per 10,000

Suicide Mortality Rate per 100,000, Age-adjusted 4.8 per 100,000

160

Appendix 1 - Sources of Data

National Center for Health Statistics Population Estimates

New York State and county population estimates by race and Hispanic origin were obtained from the National Center for Health Statistics (NCHS)*. These estimates were prepared under a collaborative arrangement with the U.S. Census Bureau.

All rates for indicators presented in this report for the three-year period, 2006-2008, use the mid-year population estimate from the 2007 NCHS bridged race population estimates file. The first indicator of population presented in this report is from the 2008 NCHS bridged race population estimates file.

Population data contained in this report use the following race/ethnicity groupings: White non-Hispanic, Black non-Hispanic, Asian/Pacific Islander non-Hispanic, and Hispanic.

* National Center for Health Statistics bridged-race population estimates, http://www.cdc.gov/nchs/nvss/bridged_race.htm

American Community Survey

The American Community Survey is part of the Census Bureau’s re-engineered census process. It is designed to provide a fresh look at how communities are changing. The survey collects housing, demographic, social, and economic information annually from a representative sample of not only the nation, but also of states and large urban counties.

American Community Survey-based indicators contained in this report are from the 2006-2008 American Community Survey three-year year estimates and use the following race/ethnicity groupings: White non-Hispanic, Black, Asian, and Hispanic. Note that, unlike other race/ethnicity groupings utilized in this report, the American Community survey groupings are not mutually exclusive. That is, the Black and Asian categories include Hispanics; the Hispanic category includes all races.

Vital Records

Information on mortality and natality are generated from birth, death, and fetal death files that are managed by the NYSDOH Bureau of Biometrics and Health Statistics (BBHS). These files also include records from New York City, a separate vital registration district.

Mortality rates (excluding cancer mortality) contained in this report are from the BBHS death files from 2006 to 2008. The cause of death is the underlying cause classified according to the International Classification of Diseases (ICD-10). All mortality rates that are not age-specific are age-adjusted using the standard 2000 U.S. population.

161

Infant mortality rates are presented for the time period 2006-2008, and are based on all live births regardless of birth weight or gestation. Rates for the three year period are based on deaths and live births that occurred during that three year period.

Natality rates are generated from the BBHS birth files from 2006 to 2008. Pregnancy rates also include the 2006 to 2008 fetal death (spontaneous and induced) files.

Mortality and natality indicators contained in this report use the following race/ethnicity groupings: White non-Hispanic, Black non-Hispanic, Asian/Pacific Islander non-Hispanic and Hispanic that are not age-specific.


Data on hospitalizations are collected through the hospital inpatient discharge data system. Each hospitalization receives an ICD-9 code at discharge which indicates the primary reason for the hospitalization. Data are not available on events that did not result in a hospitalization, such as cases that were only treated in a hospital emergency room.

Hospitalization rates contained in this report are from 2006 – 2008 SPARCS files. All hospitalization rates that are not age-specific are age-adjusted using the standard 2000 U.S. population.

Hospitalization-based indicators contained in this report use the following race/ethnicity groupings: White non-Hispanic, Black non-Hispanic, Asian/Pacific Islander non-Hispanic and Hispanic.


The Cancer Registry collects, processes, and reports cancer statistics on incidence, mortality and stages of diagnoses by site. In addition to collecting information on the anatomic site of the tumor and stage of diagnosis, the registry also collects socio-demographic information, such as age, gender, ethnicity, race and residence for each individual diagnosed with cancer.

This report presents incidence, mortality and stage of diagnosis information from the NYS Cancer Registry. Incidence and mortality rates are age-adjusted using the standard 2000 U.S. population. Five year (2003-2007) incidence and mortality rates for selected sites are presented. This report also contains early stage diagnoses for the selected cancer sites. Early stage cancers are those which are confined to the organ of origin. These percentages are presented for the same five year time period (2003-2007).

Cancer Registry-based indicators contained in this report use the same race/ethnicity groupings used for the natality and mortality data: White non-Hispanic, Black non-Hispanic, Asian Pacific Islander non-Hispanic and Hispanic.

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Appendix 2 - Glossary / Technical Notes

Age-adjustment – Age-adjustment is a statistical process applied to rates of death, hospitalization, disease, or other health outcomes, which allows areas with different age structures to be compared. Age confounding occurs when the two populations being compared have different age distributions and the probability of the outcome varies across age groups. The process of age adjustment (Direct Method) used for this report changes the amount that each age group contributes to the average rate in each area, so that the overall rates are based on the same age structure. Rates based on the same age distribution can be compared to each other without the presence of confounding by age. Adjustment was accomplished by first multiplying the age-specific rates of death or hospitalization by age-specific weights. The weights used in the age adjustment of data are the proportion of the Standard Population (the U.S. population as enumerated by the Bureau of the Census, 2000) within each age group. The weighted rates are then summed across the age groups to give the age-adjusted rate.

ICD-9CM – The International Classification of Diseases, 9th revision Clinical Modification.

ICD-10 – The International Classification of Diseases, 10th revision.

Incidence – The number of new cases of the disease or condition within a specified period of time.

Incidence rate – Cases of disease or condition in the given year(s) divided by the population at risk in given year(s).

Mortality – Death due to the disease or condition in question.

Mortality rate – Total number of deaths from the disease or condition in given year(s) divided by the population at risk in given year(s).

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Acknowledgements – New York State Department of Health Richard F. Daines, MD Commissioner of Health Office of Public Health Guthrie Birkhead, MD, MPH Deputy Commissioner, Office of Public Health Ellen J. Anderson, MS Deputy Director, Office of Public Health Office of Minority Health Wilma Waithe, PhD, RD, CD/N Director, Office of Minority Health Rodolfo Santos, LMSW Grant Manager Dina Addario Downstate Regional Manager New York State Minority Health Council Office of Public Health Practice Sylvia Pirani, MS, MPH Director, Office of Public Health Practice Trang Nguyen, MD, DrPH, MPH Director, Public Health Information Group Michael Medvesky, MPH Former Director, Public Health Information Group Pamela Sheehan Program Research Specialist Public Health Information Group David Wikoff Program Research Specialist Public Health Information Group Aaron Mair Program Research Specialist Public Health Information Group Linda Coney Administrative Assistant Public Health Information Group

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